Epidemic of obesity increased number of high-risk pregnancies
This is according to Patrick M. Catalano, MD, the Dierker-Biscotti Women's Health and Wellness Professor and Director of the Center for Reproductive Health at MetroHealth and Director of the Clinical Research Unit of the Case Western Reserve University.
Dr. Catalano collaborated with a team of clinicians and scientists from around the world to address these issues in a series of review papers on maternal obesity published this month in The Lancet Diabetes and Endocrinology.
"The management of obesity in pregnancy begins before, during and after pregnancy," said Dr. Catalano. "There is limited evidence based data on how best to mitigate adverse metabolic effects of obesity on mothers (spontaneous miscarriage, gestational diabetes, pre-eclampsia and need for cesarean delivery) and their offspring (congenital anomalies, neonatal adiposity and risk for childhood obesity) once a woman is pregnant.
"Basic questions as to what is the optimal diet or weight gain during pregnancy need to be addressed.
"In the interim, until a comprehensive potentially personalized life-course approach is instituted, efforts during pregnancy will by necessity be aimed at recognizing and mitigating the adverse metabolic consequences of maternal obesity during pregnancy on both the mother and her child."
He said that lifestyle modifications such as healthy eating, physical activity and behavioral modifications during pregnancy have had limited benefits on improving adverse perinatal outcomes, with the exception of reducing excessive gestational weight gain, on the average of two to five pounds in obese women. ■