Keeping a healthy weight for a healthy pregnancy
Publication Date:06/12/2007
Being very overweight during pregnancy increases a woman’s chances of life-threatening illness or complications. A new report shows it may even increase the risk of a woman dying during pregnancy or childbirth. Women need help to manage their weight before and during pregnancy, the report’s authors say.
What do we know already?
Women expect to put on weight during pregnancy. But putting on too much weight can be risky for your health, and that of your baby. Pregnancy puts a lot of strain on the body. It's best to be a healthy weight to start with, so your body is better able to deal with pregnancy.
Doctors measure weight using the Body Mass Index (BMI), which is your weight in kilograms, divided by your height in metres squared. If your BMI is 30 or more at the start of pregnancy, you are very overweight. Doctors call this obesity.
These are some of the problems that are more common for pregnant women who are very overweight:
- Miscarriage in early pregnancy
- Diabetes in pregnancy
- Pre-eclampsia (dangerously high blood pressure)
- Blood clots.
Women who are very overweight are also more likely to need a caesarean section, to have heavy bleeding during or after the birth, and have more risk of an infection after a caesarean operation.
What does the new report say?
Death during pregnancy and childbirth is thankfully very rare in the UK. The latest figures show there are 1.4 deaths for every million women who gave birth. But doctors think it's very important to see what can be done to avoid these deaths in future. So they carry out a study every three years looking at all deaths in pregnancy and childbirth, to see what the main causes are and to make recommendations about how they can be avoided.
The latest report, covering the years 2003, 2004 and 2005, found that heart disease, blood clots and pre-eclampsia (high blood pressure) were the most common causes of death during pregnancy and childbirth. The authors of the report said women and doctors needed to know that being very overweight can increase the likelihood of these problems.
The report says women who are very overweight when planning a pregnancy, or when they become pregnant, need help to manage their weight. Their doctors and midwives should be aware that they have increased risks of illness and problems during pregnancy, and should plan their maternity care as soon as possible to try to avoid these risks.
Doctors also need to be more alert to symptoms that could suggest a pregnant woman is becoming ill, especially if she is overweight, the authors of the report say.
Tell me more about the report's findings
Half the women who died during the three years studied were overweight. That's much higher than the population in general.
There were 41 deaths from blood clots (thromboembolism) during the study. 65 percent of these deaths were in women who were overweight or obese. And 69 percent of the 48 women who died from heart disease were overweight. Half the 18 women who died from pre-eclampsia were overweight.
We don't know whether these deaths could have been avoided if the women had been a healthy weight. But we do know that pregnancy and being overweight both put a strain on the heart, and increase your chances of having blood clots and high blood pressure.
Other causes of deaths during pregnancy and childbirth were heavy bleeding, infection, reactions to the anaesthetic and mental health problems, including suicide and overdose.
Where does the report come from?
The report was written by doctors for the Confidential Enquiry into Maternal and Child Health. This organisation was set up in 2003 and is run jointly by the Royal Colleges of Obstetricians and Gynaecologists, Anaesthetists, General Practitioners, Midwives, Paediatrics and Child Health, Pathologists and Psychiatrists, and the Faculty of Public Health.
How reliable are the findings?
Researchers from the Confidential Enquiry follow up all reported deaths of women during pregnancy and the six weeks after childbirth. They carry out interviews and look at case notes to find out what happened. Every three years, they publish a big report giving an overview of the reasons for deaths in pregnancy and childbirth, and draw lessons from them.
The Confidential Enquiry has a very good reputation for thorough and accurate reports. Of course, the report relies on accurate records being kept by hospitals.
What does this mean for me?
Remember that most women in the UK have a healthy pregnancy and give birth without any serious problems. Weight is just one of the things that affect your chances of having a healthy pregnancy. Other things, like your age, your general health, how many children you've had and whether you've had problems in previous pregnancies, are also important.
But it does make sense to ensure you are in good shape before you get pregnant, as much as possible. Your GP or practice nurse should be able to tell you how to plan for a healthy pregnancy.
What should I do now?
If you're pregnant or planning a pregnancy and you're worried about your weight, talk to your GP or midwife. They can help you avoid putting on too much extra weight, with advice on a healthy diet and safe exercise.
If you are very overweight, it's important that the people planning your maternity care know that you are at higher risk of complications. You might find it embarrassing, but it's worth talking to your midwife and asking whether you will need extra care.
It's also important to make sure you go along to all your antenatal appointments and checks. These appointments can help doctors or midwives pick up any problems early, before they become serious.
From:
The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer - 2003-2005. The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. Lewis G, ed. London: CEMACH; 2007.
To find out more about how to manage your weight, see our information on obesity. To find out more about problems that may happen in pregnancy and childbirth, visit our pregnancy and childbirth section.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
