RATES of obesity among pregnant women are at an epidemic level, exacerbated by poor awareness of the dangers and myths such as “eating for two”, health experts say.
Almost one in six women are obese at the start of pregnancy, according to the National Institute for Health and Clinical Excellence (Nice), the British NHS watchdog for best practice, which is publishing guidance on weight management before, during and after pregnancy.
About half of women of childbearing age are either overweight, with a body mass index of 25-29.9, or obese, with a BMI of 30 or above.
Lucilla Poston, director of maternal and foetal research at King’s College London, said that the recommendations – which are aimed at health professionals such as GPs, midwives and pharmacists – were “incredibly timely [given] the epidemic of obesity among our pregnant population”.
The guidance outlines the importance in achieving a healthy weight and BMI before pregnancy, keeping weight down between children and avoiding “crash dieting” in pregnancy. It emphasises that there is no need to “eat for two” and women should instead follow sensible eating habits to avoid unnecessary weight gain.
Professor Poston said that obese women faced a greater risk of “almost every complication in the book in pregnancy”, including pre-eclampsia, gestational diabetes, miscarriage and maternal death. At her ante-natal clinics there had been an “exponential increase” in obesity among those attending.
The guidance recommends detailed discussions of diet and habits with all women with a BMI of more than 25, while those with a BMI greater than 30 should be offered advice on losing weight before pregnancy. Such women should not be encouraged to diet during pregnancy, but offered guidance from dieticians on avoiding further weight gain and managing the associated risks.
Research suggests that obese women are more likely to have an induced or longer labour, instrumental delivery, Caesarean section or a postpartum haemorrhage. They also have reduced choices on how and when they give birth.
Babies born to obese women face risks such as stillbirth, congenital abnormality and an increased likelihood of obesity in childhood. Obesity can also cause problems with breastfeeding.
Annie Anderson, professor of food choice at the University of Dundee’s Centre for Public Health Nutrition Research, said: “Pregnancy is absolutely not the time to diet or lose weight, but neither is it desirable to eat for two. That’s one of myths out there.”
She said that perceptions of extreme weight loss after childbirth conveyed by photographs of celebrities often made the task more daunting. Some women took offence at any discussion of their weight.
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