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318 Cardio Diabetes Medicine 2017

Maternal Obesity and

Pregnancy Outcomes

Dr. Archana Ambujan
MS(OG)., DRM (Germany)
Consultant in OBG & Fertility Specialist,
Sundaram Arulrhaj Hospitals, Tuticorin

Introduction the abdomen at the level of the umbilicus. It is an
“HEALTH IS WEALTH “ is an Old English Saying indicator of health risks associated with excess fat
.Weight is an indicator of general health of a person. around the waist. A waist circumference more than
Being Underweight is not considered healthy & so is 88cm (or 35 inches) in women is associated with
being Overweight. health problems like Diabetes ,Hypertension & Heart
Disease.
Obesity is a Silent Epidemic emerging gradually all
over the world. Worldwide obesity has more than Obesity may be Central Obesity which is android
doubled between 1980 &2014.There is a higher prev- type with apple shaped fat distribution or Lower body
alence of obesity in females than males. According Obesity which is Gynaecoid type with pearshaped fat
to WHO (2014) in the Global scenario more than 1.9 distribution .Central Obesity is at high risk for Co-
billion individuals are overweight and more than 600 morbidities & Complications.
million are obese .26 % Non pregnant women in the
age group of 20-39 are either overweight or obese. Obesity & Pregnancy
Increasing rate of Maternal obesity is a major chal-
India stands third in the world in the incidence of lenge to obstetric practice.Maternal Obesity has a
obesity only next to China & US & India is racing detrimental effect on both the Mother & Baby .Ma-
ahead to the top. More than 30 million people in India ternal risks during pregnancy include Gestational
are obese.
Diabetes & Preeclampsia. Fetal risks during preg-
Hence “Obesity “is the no longer a “Disorder”, but it nancy include congential anomalies & stillbirth Ma-
is a “Disease” of serious concern. ternal obesity can pose problems before pregnancy
with inability to conceive (Infertility),during pregnancy
Definition both antepartum & peripartum,neonatal problems&
According to WHO ,Overweight & Obesity are defined longterm complications.
as abnormal or excessive fat accumulation that pres-
ents a risk to health .It is estimated by BMI and waist Infertility
circumference. The beginning of the problems of Maternal obesi-
ty is Infertility.An Obese women is about thrice as
BMI is used as a measure of Obesity. It is the ratio
of the weight to square of height of a person (kg/m ) likely to be in fertile as a normal woman.It is seen
2
that adolescent obesity is associated with a threefold
WHO recommended cut offs for BMI increased risk. Obesity is strongly associated with
PCOS ,a disorder which is characterized by central.
Underweight ≤ 18.5 Kg/m2 obesity, hyperandrogenism &insulin resistance with
Normal BMI 18.5-24.9 Kg/m2 compensatory hyperinsulinemia. Obesity also leads
to poorer prognosis in women undergoing various
Over Weight 25.0-29.9 Kg/m2
Assisted Reproductive treatments.Pregnancy rates in
Obesity ≥30 Kg/m2 ART is halved for women with BMI>35kg/m2.In IVF
Waist circumference is a measurement taken around also obese women require higher doses of gonado-

GCDC 2017