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The impact of obesity on pregnancy: plus a kilo - plus a complication! Overweight and obesity during pregnancy

The course of pregnancy in women with obesity has some features and risks for the baby. Expectant mothers who have not managed to stabilize their weight before conception and childbirth should take into account information about the development of possible complications and follow the advice of experienced professionals.

Obesity is a disease

There is a widespread misconception that excess weight does not affect pregnancy, but only affects appearance and is purely a cosmetic defect. But it's not. First of all, obesity is a pathological condition characterized by a malfunction of metabolic processes and entails the formation of excess adipose tissue in the body.

Predisposing factors for development are:

  • genetic predisposition to be overweight, especially if both parents suffer from the disease;
  • low physical activity;
  • overeating and malnutrition, including fast food, sweet and high-calorie foods;
  • hormonal disorders.

What degree is considered dangerous

To reliably establish obesity, we use the body mass index (BMI) - the ratio of a person's height and weight. The recognized norm is considered to be the final indicators from 18.5 to 25. Depending on its excess, experts have identified the following degrees of obesity:

  • The first - in excess of 11-29%;
  • The second - by 30-49%;
  • The third - by 50-95%;
  • The fourth is over 96%.

In the process of bearing a child, obesity can worsen. This is due to the fact that during this period, comfortable conditions are created in the female body for the accelerated development of the fat layer.

It is a fact. It has been proven that the initial indicators of the body weight of the expectant mother and the total weight gain during pregnancy are the determining factor in the overall course of the gestational period, delivery, as well as possible complications and weight indicators of the newborn.

At the same time, obesity of the 1st degree often has a negative impact on the intrauterine development of the fetus. Grade 2 - is fraught with complications in about 75-80% of clinical cases. A 3 and - entails complications of childbirth in 100% of women.

The determining indicator of the risk of neonatal pathologies and mortality, as well as the comprehensive health of the child, is the weight of the newborn. Reduced birth weight indicators predetermine the possible occurrence of diabetes mellitus, coronary heart disease and arterial hypertension. Therefore, the control of weight gain is considered extremely important, especially in women with an initial failure in the work of metabolic processes.

Possible Complications

Excess fat in the female body leads to a violation of the formation of eggs. It provokes the risks of pregnancy and childbirth and contributes to the development of certain complications in the process of conception, gestation, which include:

  1. Gestosis

Contribute to the occurrence of violations in the work of all organs and systems. With severe obesity, preeclampsia can occur, characterized by high blood pressure, visual impairment (up to loss), and the appearance of large amounts of protein in the urine.

  1. Hypercoagulability

It is an increase in the rate of blood clotting and carries a threat in the form of blood clots, fetal growth retardation and placental insufficiency.

  1. Diabetes

It may appear as a result of hormonal surges. It is explained by the production by the placenta of certain substances that create a barrier to the absorption of insulin. The result is an increase in the concentration of glucose in the blood of the expectant mother.

  1. Arterial hypertension

Representing an increase in pressure. Such a complication can provoke premature rupture of amniotic fluid and subsequent childbirth.

  1. Miscarriage

Obese pregnant women are at risk of miscarriage, especially before 12 weeks of gestation, and much premature delivery.

  1. C-section

Delivery in obesity has its own characteristics. Women in labor often have situations that can only be resolved by caesarean section. Excess weight aggravates the course of the postoperative period with the possible attachment of infections and prolonged healing of the wound surface.

  1. Overbearing of the fetus
  1. Obstructive cessation of breathing during sleep

For reference. Obese women in labor are more likely to require induction of labor and the use of anesthetic blockades.

Obesity and pregnancy are characterized by a colossal load on the heart muscle, which is unable to adapt to the accelerated regimen. As a result, the development of hypertrophy of the left atrium and myocardium is possible.

Management of pregnancy

Based on the above threats to the life and health of an expectant mother with initially overweight, the following requirements are paramount for the attending doctor:

  • establishment of permissible weight gain;
  • carrying out preventive measures that prevent complications;
  • timely diagnosis and exclusion of gestational diabetes;
  • prevention or early detection of fetal macrosomia (weight gain over 4000 g);
  • determination of an adequate term and method of delivery of the patient.

Pregnancy management in patients with obesity requires continuous monitoring of the condition of the fetus and mother, and additional diagnostics. The fundamental principles of observation are:

  • dynamic monitoring of blood glucose;
  • control of hemoglobin level;
  • prevention and treatment of obstetric pathologies;
  • assessment and prevention of diabetogenic phenomena, including consultation with an ophthalmologist, urine tests to determine daily proteinuria, as well as blood creatinine;
  • monitoring the state of fetal development (ultrasound at the scheduled time and doplerometry, CTG weekly, starting from 33 weeks).

Nutrition Features

During the period of bearing a child, the problem of increased body weight should not be left to chance. Even at this time, it is quite possible to control weight gain. The use of medications, as well as for this purpose, is contraindicated. But the competent filling of the grocery basket will allow you to keep weight under control.

The diet for women in an interesting position suggests a daily intake of 35-40 kcal / kg, given that the total calorie content should be no less than 1850 and no more than 2450 kcal. The main part of the diet should be carbohydrates, about 35% fats and 15% proteins. The daily menu should be divided into 3 main meals and 3 snacks.

Obesity of pregnant women requires a competent choice of products consisting of three food groups:

1 group(allowed to use without significant restrictions):

  • vegetables (, tomatoes, bell peppers, radishes, green peas, green beans);
  • cereals, spinach, lettuce;
  • products containing soy;
  • greens, berries and mushrooms.

2 group(daily moderate consumption is acceptable):

  • baked potatoes, corn;
  • cereals, pasta and bakery products from wholemeal flour;
  • raw eggs, dairy products with a zero percent fat content;
  • lean meat (rabbit and chicken fillet, turkey);
  • lean fish;
  • fruits (with the exception of grapes, melons, dates and bananas).

3 group(minimum consumption allowed):

  • salmon caviar, canned fish in oil;
  • fatty pork and fish;
  • sausages and semi-finished meat products;
  • cocoa, coffee;
  • confectionery, sugar, chocolate, sweets, honey, jam.

Note! Individually selected fasting days will help control weight gain and improve digestion. They can be fruit, for example, apple, as well as sour-milk and cottage cheese.

Physical activity

Obesity during pregnancy requires the activation of normal metabolic processes, not only by reducing the calorie content of foods, but also by increasing physical activity in the absence of medical contraindications.

To prepare the body for childbirth and stabilize body weight, daily is suitable. Thanks to this load, the body is actively saturated with oxygen, accelerating the metabolic process. At the same time, the mood will definitely improve.

The simplest exercises contribute to improved blood supply to tissues and organs, maintaining optimal muscle tone. Daily loads lead to the normalization of the elasticity of the skin, muscular and ligamentous apparatus and are an excellent preventive measure to prevent gynecological ruptures during childbirth. Expectant mothers will benefit from therapeutic exercises and water aerobics.

Features of the course of pregnancy against the background of obesity are characterized by the occurrence of many pathologies, both in a woman and in an infant. During the period of bearing a child, the woman's body is rebuilt and enters the mode of active weight gain. Therefore, it is important to take control of nutrition and resort to physical activity.

Excess weight during pregnancy (or obesity) can cause complications for the expectant mother and for the child. Moreover, the higher the likelihood of developing complications of pregnancy. But there are things (we'll cover them below) that you can do before and during pregnancy to help you carry a healthy baby.

To know if you are overweight, you need. BMI is a measure that is the ratio of your weight to your height. It makes no sense to calculate BMI during pregnancy, because you never know for sure how much the baby, placenta and amniotic fluid weigh.

If you were overweight before pregnancy, your BMI will be between 25 and 29.9. Approximately 1 in 3 women (33%) of reproductive age (15 to 44 years) is overweight. If you were obese before pregnancy, your BMI will be 30 or higher. Approximately 1 in 5 women (20%) is obese.

Excess weight for women (both pregnant and non-pregnant) is dangerous because it can cause:

  • endocrine disorders;
  • diseases of the cardiovascular system;
  • varicose veins, especially veins in the legs.

Pregnancy complications caused by being overweight

An overweight woman (and even more so an obese woman!) is much more likely than a normal weight pregnant woman to develop certain health problems during pregnancy, which include:

  • decreased fertility (leads to difficulty conceiving);
  • infertility,
  • miscarriage;
  • stillbirth;
  • delayed fetal development;
  • high blood pressure (hypertension) and preeclampsia;
  • premature discharge of amniotic fluid;
  • complications during childbirth (severe blood loss, development of urinary tract infections);
  • the need for a caesarean section (due to the fact that the woman has a too large fetus).

Some of these problems, such as preeclampsia, increase the risk of preterm birth, and having a baby early can lead to health problems.

Most children whose mothers are obese or overweight are born healthy. But if a mother was obese during pregnancy, it can cause health problems for her baby. These issues include:

  • birth defects, in particular neural tube defects (NTDs), affecting the baby's brain and spinal cord;
  • oxygen starvation (hypoxia);
  • lack of nutrients;
  • prematurity (if the baby is born prematurely);
  • and birth injuries (shoulders are most often affected), caused by the fact that the child is too big;
  • the risk of developing diseases of the central nervous system, heart disease and neuralgia (convulsive syndrome);
  • death of a child after birth;
  • obesity in a child in childhood.

What can you do?

1. Before conceiving a child, be sure to undergo a medical examination. Your doctor can choose a special diet and exercise program that is effective for burning fat (if the doctor cannot do this himself, he will refer you to narrow-profile specialists - a nutritionist, fitness trainer). These activities will help you lose weight before you get pregnant.

2. Get registered for pregnancy as early as possible and attend all prenatal appointments with a gynecologist! Do not neglect a visit to the doctor, even if you think that everything is fine with you!

3. Ask your doctor what weight gain during pregnancy is best for you. Keep in mind that overweight women should gain no more than 6.8 - 11.3 kg during their entire pregnancy. And women suffering from obesity should not gain more than 4.9 - 9.0 kg per pregnancy.

4. Don't try to lose weight while pregnant! Now is not the time to go on a diet! Most diets cut off the nutrients your child needs for growth and health. It is better to talk to a nutritionist who will help you plan your meals. We remind you that a woman's nutrition during pregnancy should be as balanced and healthy as possible!

5. Do more exercise if you have no contraindications to this. Walking, swimming, cycling, prenatal gymnastics, and yoga are all safe forms of exercise during pregnancy.

6. Many women, trying to lose weight, completely exclude fat from the diet. This cannot be done! Fat is essential for the normal development of the fetus, it is better to reduce the consumption of simple carbohydrates (white bread, rice, sweets, starchy foods), so enrich your diet with healthy foods containing fats and proteins, such as sour cream, whole milk, cheese, eggs, chicken white meat ( skinless), butter, yogurt, lean fish. If you are obese, then whole milk, sour cream and yogurt are best replaced with fat-free ones.

7. Limit the use of salt, it contributes to fluid retention in the body, and, accordingly, can cause swelling. It is also worth limiting tea, chocolate and coffee, which not only contain a lot of caffeine, but also give you extra, unnecessary calories, and complicate the body's absorption of folic acid, iron and calcium.

8. Do not overeat, portions should be small. It is better to eat several times a day. Overweight women are advised to reduce their daily calorie requirement by 10-15% (if you are carrying a multiple pregnancy, then you should definitely consult a nutritionist about how many calories you need).

If you are overweight during pregnancy, the main thing is not to go to extremes, do not starve, but simply learn to control your appetite and weight! Keep in mind that fasting is fraught with consequences such as miscarriage, insufficient fetal weight gain, brain damage and metabolic disorders in the child.

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The modern world rehabilitates puffies. A full woman is sexy - say the media. Even famous couturiers create collections for fat women and release XXL models on the catwalk. Is it possible to get pregnant with obesity and is it necessary to lose weight before pregnancy? Isn't it better to give up diets and just enjoy life in your big body? Let's see what doctors think about this.

Before planning a pregnancy, you need to determine your ideal weight for conceiving a child. And this is not a model weight at all. Exhaustion has the same negative (if not worse!) effect on conception as excess weight.

One of the most popular diagnostic methods is the calculation of BMI (body mass index). In order to calculate the index, you need to know your weight and height.

BMI = weight in kg / height in meters squared.

For example, let's calculate BMI with a height of 170 and a weight of 60 kg.

BMI=60/1.7X1.7

The ideal weight for conception should be as close as possible to normal BMI - 18-25. Being underweight or overweight can interfere with pregnancy.

Significant deviations from the norm are underweight and obesity.

Is it always necessary to lose weight

First you need to determine the cause of the high BMI. It should be understood that overweight is not always obese. Sometimes “excess” weight is swelling (for certain diseases) or an individual feature.

They talk about an individual feature in the case when the BMI is above the norm, but the proportions of the body are observed. This phenomenon can be observed in athletes with well-developed muscles and dense bone tissue.

Spanish volleyball player LILI

World No. 1 Serena Williams

In any case, with borderline values, it is necessary to take into account the proportionality of your body. Muscle tissue is much denser than adipose tissue, therefore, its contribution to the total body weight is more significant.

There are methods for calculating the percentage of adipose tissue in the body. At home, this percentage cannot be determined. Such diagnostics are done in private clinics, in public health centers, as well as in fitness centers. The norm for conception is 17-25%. If your BMI is above normal, but the fat content does not exceed 25%, then losing weight is not necessary for conception.

How completeness affects conception

The weight or body weight of a person plays an important role in the regulation of the hormonal background of a woman. In this case, it is not the mass itself that matters, but the fat content in the body. For example, a broad-boned girl weighing 67 kg, most likely, does not have excess fat. And if a short, asthenic girl with thin wrists weighs the same, then she does not interfere with losing weight.

In recent years, doctors have discovered that subcutaneous fat is essentially a large endocrine (that is, hormone-producing) organ. Obesity is a hormonal disease. With obesity in the body, changes in the endocrine system occur. Hormonal failure leads to metabolic disorders by the type of lipogenesis. In this case, in the body, fat begins to form from carbohydrates and is deposited in the subcutaneous fat.

The exact mechanism of how body weight affects conception is not described in the medical literature. Excess body weight does not have a direct impact on the reproductive function of a woman. But in favor of the fact that excess weight prevents pregnancy, many observations of doctors speak.

Sex hormones and obesity

Any hormonal disorders in the body are not isolated. Ovulation in a woman's body occurs under the influence of sex hormones. Sex hormones include estrogen and progestogens. Estrogens are synthesized in the ovaries and affect ovulation. Progestogens or pregnancy hormones are synthesized by the corpus luteum, placenta and a small part of the adrenal cortex.

Normal body weight depends on the physique.

The formation of the egg, its ability to fertilize and successful implantation of the embryo also occurs under the influence of sex hormones. Uncoordinated work of estrogens and progestogens leads to an unsuccessful attempt at conception.

It is possible to determine whether weight affects conception by the presence of hormonal disorders of sexual function. Sex hormones regulate all processes preceding conception: ovulation and the movement of the egg through the fallopian tube, the function of the corpus luteum and endometrium.

When the egg is fertilized, the regulation of sex hormones continues. Successful implantation of the embryo into the endometrium and successful formation of chorionic villi also depend on the production of estrogen and progesterone.

Hormonal imbalance in the body can affect the ability to conceive. And adipose tissue, in turn, affects the synthesis of sex hormones. If there is too much of it or, conversely, too little, then the hormonal balance is disturbed, and there may be no ovulation and conception.

obesity and infertility

Does Being Overweight Affect Conception? It has been found that overweight people find it difficult to conceive a child. Many experts link overweight and infertility.

At the same time, one can speak of infertility only in the case when unsuccessful attempts to get pregnant have occurred for more than one year. Unsuccessful conception from the first attempts can be a physiological norm.

You can't get pregnant for a long time and your doctor says that you have hormonal problems (for example, there is no ovulation, corpus luteum function is impaired, etc.)? Perhaps the reason lies in your obesity. With weight loss, the balance of hormones can be restored. Although it is possible that in addition to obesity, you have other causes of infertility. Therefore, do not take "weight loss" measures as a panacea. You need to be examined and treated.

What is the risk

It has been established that in women, obesity of the 2nd and 3rd degrees contribute to the disruption of the menstrual cycle and ovulation. Although there is no unequivocal answer to the question of why being overweight affects conception, there is no one in modern medicine.

To determine whether it is possible to become pregnant with obesity of the 1st degree, it is possible after examining the hormonal background of a woman for the functioning of sex hormones. Often a small deviation from the norm does not affect the reproductive system.

However, even mild obesity will make carrying a baby physically exhausting for you. Not to mention serious deviations from the norm. Pregnancy with obesity often becomes a high-risk pregnancy. High blood pressure, swelling, varicose veins, heart problems - this is not a complete list of complications. Therefore, fat women should lose weight before conception, even if the hormonal background is normal.

How to lose weight to conceive

When planning a pregnancy, you need to determine your ideal weight for conception. If you are overweight, then you need to lose weight in order to get pregnant. There are many ways to lose weight and improve your fitness. To achieve a positive result, you need to review your diet.

Proper nutrition and physical activity contribute to the reduction of adipose tissue and the development of muscle. Sufficient intake of carbohydrates, proteins and fats normalizes the metabolism in the body. And physical training will help a woman cope with pregnancy and prepare for childbirth.

"Extreme" weight loss is impossible. Low-calorie and especially low-fat diets hurt a woman's endocrine system. Menstruation may stop, ovulation will disappear. Be sure to include fats in your diet (albeit in modest amounts). And the total caloric content of the diet when losing weight should not fall below 1500 kcal per day.

Exhausting physical activity, especially for unathletic women, will also not bring anything but harm. You need to do a little, gradually increasing the intensity of the exercises.

You need to lose weight slowly (about 0.5 kilos per week), otherwise rapid weight loss will exacerbate hormonal problems.

got pregnant and lost weight

Sometimes the pregnancy itself introduces an adjustment into the woman's body. In the first trimester, intoxications or early preeclampsia of pregnant women often develop. Clinically, preeclampsia is expressed in dyspeptic disorders.

With dyspepsia, pregnant women suffer from nausea, vomiting and loss of appetite. In such cases, they say "got pregnant and lost weight." Preeclampsia during pregnancy is an undesirable phenomenon, since the child from the first days of its development must receive the necessary amount of nutrients and minerals.

To determine whether your excess weight affects conception, you need to each on your own. With any fluctuations in the direction of excess weight, be sure to lose weight. Optimal body weight, good health of a woman shape the future health of a child.

Competently: gynecologist's comment

Obstetrician-gynecologist Elena Artemyeva answers questions from patients

— My height is 172 and weight is 51 kg. The monthly cycle is irregular. I haven't been able to get pregnant for four years now. Doctors say it's because of the weight and recommend IVF. Will it be possible to bear a child after IVF, given the lack of body weight?

- Your ideal weight for conception is in the range of 55-73 kg. If for some reason it is not possible to recover to these numbers and if it is not possible to get pregnant for so long, IVF is recommended. You will be able to bear a child, but try to eat very well during pregnancy.

- I'm 28 years old. We have been planning a child for 7 months, but fertilization does not occur. My husband and I went through an examination, everything is fine. With a height of 168 cm, I weigh 94 kilograms. I should lose weight, but I don’t know how the diet will affect conception. I want to try a vegetable diet.

- Weight for conceiving a child really matters. Losing weight is good for you, losing weight will increase the chances of conception. But rigid diets adversely affect the hormonal background. The diet should be balanced, and in a strict vegetable diet, proteins and fats are practically absent.

I have been overweight since childhood. Now I weigh 95 kg. My gynecologist said that the chances of pregnancy are low until I lose weight. What nutrition is necessary before planning a pregnancy and how to lose weight?

- You need to be examined by an endocrinologist. Often, with the endocrine form of obesity, special approaches are needed, and nutritional correction will not be enough. Be patient, you can't lose weight quickly. First of all, you need to organize the food. The calorie content of the daily diet is 1700-1900 kcal. You need to eat often, but little by little (5-6 meals). Focus on light foods - vegetables, fruits, low-fat sour milk, fish. Drink plenty of clean water - at least 2 liters. Don't eat at night. Eliminate smoked, salty, canned food, sweets, alcohol, limit flour. Spend at least one fasting day per week. Physical activity is required.

The human body is designed in such a way that important organs are protected from temperature extremes by a fatty layer. In conditions of insufficient intake of nutrients, along with food, subcutaneous fat is transformed into the necessary energy. However, it happens that the body begins to accumulate fat in an enhanced mode, even without being in conditions of hunger, excess weight appears, and sometimes even the problem of obesity arises. Often with extra pounds come such companions as hypertension, diabetes, varicose veins, atherosclerosis, various arthrosis.

Among the main causes of obesity are an unbalanced diet (for example, eating a large amount of easily digestible carbohydrates), a genetic predisposition, endocrine gland disorders, poor physical activity associated with sedentary work, using transport instead of walking, lack of physical activity in general.

But if under normal conditions a woman may not attach much importance to excessive weight and not want to change her lifestyle, then you need to know that excess weight during pregnancy can be a sign and cause of various pathologies in the nascent organism.

Danger of gaining excess weight during pregnancy

During the gestation of the fetus, the female body goes into active weight gain, which is the norm, because. the placenta with amniotic fluid and the baby itself are constantly growing. In addition, the mammary glands increase in size, the fat layer thickens to protect the baby from the effects of the external environment and in case of a shortage of food. At the same time, doctors carefully monitor for many months so that there is no gain in excess weight during pregnancy.

Normally, the increase is about 8-12 kg for all 10 months, depending on the initial weight of the woman, and accelerated weight gain may occur due to fluid retention, which is a symptom of preeclampsia and dangerous edema. In addition, excess weight during pregnancy often leads to varicose veins and hemorrhoids, which can cause not only discomfort, but a real problem, especially in the postpartum period; increased blood pressure, which is fraught with the development of seizures; the appearance of back pain and shortness of breath, which can be expressed in a lack of oxygen in a child - hypoxia; the development of diabetes; loss of tissue elasticity, which can lead to ruptures and other serious consequences in childbirth.

If overweight has turned into obesity during pregnancy, then doctors treat such women as a high risk group regarding the threat of miscarriage, weakness of labor and postpartum complications.

Pregnancy and obesity of the 1st, 2nd and 3rd degree

The degree of obesity is usually determined according to this principle: a conditional value of 100 is subtracted from the height in cm (the readings are quite accurate with a height of 155-170 cm). If the obtained value exceeds the body weight by 30%, they speak of the I degree of obesity, when the weight is exceeded by 50%, we are already talking about the 2nd degree of obesity, from 50 to 100% - about the 3rd degree, more than 100% - about 4th degree of obesity.

When carrying a baby, obesity can worsen even more, since at this time favorable conditions are created for the development of fatty tissue. At the same time, various complications associated with obesity of the 1st degree during pregnancy greatly affect the condition of the fetus. Obesity of the 2nd degree during pregnancy threatens with complications already in 70-80% of cases, pregnancy with obesity of the 3rd and 4th degree and subsequent births are complicated in 100% of women in labor. Excessive weight in the last stages causes late toxicosis, an increase in the frequency of anemia and acute respiratory diseases.

Despite all these facts, one should not assume that pregnancy and obesity are mutually exclusive concepts, but if there is overweight, a woman should be under medical supervision all this time. Managing excess weight through the establishment of a proper diet and moderate exercise can greatly alleviate the course of obese childbirth.

How to lose weight during pregnancy?

At an important time of bearing a child, the problem of overweight should not be left to chance. It is quite possible to lose weight even during pregnancy. To do this, you will have to break your diet into 6-8 meals and completely abandon sugary carbonated drinks, mayonnaise and other fatty and spicy sauces (you can replace them with healthy olive oil), seriously limit your salt intake. For a light snack during the day, you can keep dried fruits, crackers, yogurt on hand. Also, special fasting days, for example, cottage cheese, fruit, sour-milk days, can help in this matter. Before embarking on them, be sure to consult with your doctor. They need to be carried out under strict medical supervision, because any diets and fasting days during this period instantly affect the health of the unborn child.

If pregnancy is accompanied by obesity, then it is extremely necessary to restore and activate normal metabolism by reducing calories in food and increasing physical activity. The total number of calories can be very easily reduced by easily digestible carbohydrates (sugar, jam, sweets, cakes), which are also easily converted into fats in the body.

Nevertheless, carbohydrates must necessarily enter the body of a pregnant woman at least 100 g per day, for example, in the form of bread from coarse flour, cereals, vegetables and fruits, which still contain fiber that stimulates the stomach and intestines, and also a lot of vitamins and minerals.

Eating raw vegetables and fruits also helps convert excess fat into energy. You can not get rid of excessive weight during pregnancy due to proteins (meat, eggs, fish, dairy products), which are kind of building blocks for the development of the baby's body.

The daily portion of protein food during pregnancy should be at least 150 g. Steam cutlets, rolls, meatballs or zrazy can be prepared from lean meats. At the same time, beef and veal are also excellent sources of iron, which is necessary to maintain normal hemoglobin levels.

Physical activity with excess weight

There is an opinion among the people that the expectant mother should rest as often as possible, that any physical activity is contraindicated for her. Indeed, during pregnancy, especially in the last months, it becomes quite difficult to do even the simplest housework. However, to keep weight and muscle tone under control, at least minimal physical activity is necessary. After all, childbirth, in addition to its important psychological component, is a fairly serious well-coordinated work of the entire female body, which will really need strong muscles.

Not too difficult physical activity are daily walks in the park, but they add a lot in the fight against excess weight and in preparing the body for childbirth, training the muscles of the press and legs, saturating the body with oxygen, even simply charging with a good mood. In turn, the more oxygen the body receives, the more intense many of its processes, including metabolism, become.

The simplest physical exercises improve blood circulation in the tissues, help to keep the muscles in good shape. All this contributes to the preservation of elasticity and turgor of the skin, ligaments and muscles and serves as a kind of prevention of ruptures during childbirth. Many clinics hold regular classes for expectant mothers, including water aerobics and special therapeutic exercises.

Thoughtful physical exercises under the supervision of an experienced instructor stimulate an increase in metabolism, an increase in energy consumption, and with them the activation of processes in the body aimed at breaking down excess fat. It must be remembered that even if you are overweight, pregnancy is an excellent time for the birth and development of a new life, and constant control over excess body weight will be the key to a normal pregnancy and successful delivery.

Obesity is not only an excessive accumulation of adipose tissue in the body. This is a chronic severe disease that contributes to the formation of other severe pathologies affecting all organs and systems in the body. If we are talking about overweight in pregnant women, then this disease can have a negative impact on the development of the fetus. The nature and severity of the consequences for the expectant mother herself and the developing child directly depends on. Only the right approach to the treatment of overweight will help to avoid negative health effects. Despite the fact that obesity and pregnancy are compatible, this condition requires a special approach.

General concepts

In the process of bearing a child, the body of the expectant mother is faced with a radical restructuring of the hormonal background. This circumstance entails an active set of excess weight, which is a variant of the physiological norm. Additional kilograms appear due to the growth of the placenta and an increase in the volume of amniotic fluid. In addition, the mammary glands of the expectant mother increase in volume due to the growth of adipose and glandular tissue. These physiological mechanisms are aimed at ensuring the life of the unborn child. If weight gain during pregnancy does not go beyond the permissible norm, then there is no reason to panic.

Normal weight gain for the entire period of bearing a child is from 8 to 12 kg. If, before pregnancy, a woman had a problem of extra pounds, then the allowable weight gain should be no more than 6 kg. If a woman has found a sharp jump in weight, then this may indicate fluid retention in the body associated with a severe form of toxicosis (preeclampsia). Very often, obesity during pregnancy occurs against the background of such endocrine disorders as diabetes mellitus and diencephalic pathology.

Before using all sorts of methods for correcting excess weight, every pregnant woman needs to make sure that excess weight is provoked precisely by the accumulation of adipose tissue, and not by fluid retention in the body.

Degrees of obesity

In medical practice, there are 4 degrees of overweight. Moreover, the last degree is characterized by the formation of the so-called, which poses a great danger to human health and life.

  1. With the development of obesity of the first degree during pregnancy, the proper body weight increases by 30%, which creates favorable conditions for the formation of developmental pathologies in the fetus. If a pregnant woman notices a suspicious weight gain, she is advised to seek medical advice as soon as possible. With an increase in body weight of the 1st degree, a pregnant woman may feel increased fatigue, shortness of breath when walking and climbing stairs, and also observe excess deposition of adipose tissue in the thighs, buttocks and abdomen.
  2. With obesity of the 2nd degree during pregnancy, the risk of developing characteristic complications is at least 70%. This progressive serious condition leads not only to a deterioration in the well-being of the pregnant woman and the fetus, but also to a decrease in the quality of life in general. Being in the second stage, overweight begins to respond worse and worse to corrective measures. It is possible to talk about the transition of the disease to the second degree, subject to an increase in body weight from 35 to 50%.
  3. 3 and 4 degrees of obesity is a severe pathological condition in which the body weight of a pregnant woman increases from 50 to 100%, and even more. Such conditions end with the formation of severe consequences on the part of the mother and child in 100% of cases. Expectant mothers who have problems with overweight, during registration at the antenatal clinic, undergo a laboratory test for glucose tolerance. This laboratory study is designed to detect carbohydrate metabolism disorders with a view to their further correction.

For example, if a pregnant woman has a weight of 98 kg and a height of 164 cm, then the proper body weight is increased by 54.6%, which is equivalent to grade 3 obesity. If such a situation arises, the expectant mother will need to consult a therapist, endocrinologist and other medical specialists.

Consequences of excess weight in the expectant mother

If a pregnant woman suffers from body obesity of the second degree, then this condition can lead to a serious threat to her condition, as well as to the body of the developing fetus. In addition, excess body weight can cause irreversible consequences for the process of bearing a child. An obese pregnant woman is at a potential risk group for the occurrence of such complications:

  1. Spontaneous cessation of breathing during sleep (apnea). Given that a developing child puts pressure on the diaphragm, thereby complicating the breathing process, the presence of excess body weight is an additional provoking factor leading to respiratory arrest. This condition is extremely dangerous, as it can be fatal;
  2. Gestational form of diabetes. Excessive accumulation of extra pounds in the body of a future mother leads to the formation of diabetes mellitus, which is difficult to correct;
  3. Pregnancy reversal. Very often, against the background of obesity of 1 degree and above, women experience an increase in the period of bearing a child;
  4. Infectious and inflammatory diseases of the urinary tract. Pregnant women with overweight significantly increase the risk of developing urogenital infectious and inflammatory diseases, which can cause spontaneous or premature termination of pregnancy;
  5. Problem childbirth. Often, obesity is an indication for the implementation of stimulation of labor. In addition, pregnant women who are overweight are more likely to need painkillers to ease contractions;
  6. Preeclampsia. Due to the accumulation of an excess amount of adipose tissue in the body, in women, blood pressure indicators increase and protein particles are observed in the general urine test. This condition poses a threat to both the mother and the child;
  7. Impossibility of natural delivery. A large number of extra pounds is an obstacle to standard childbirth. These women are more likely to have a caesarean section. It is important to consider that obese women in labor are at high risk of intraoperative and postoperative scarring. In the case of repeated pregnancy, such patients do not have the opportunity to give birth naturally;
  8. Thrombosis of large vessels. Excess body weight during pregnancy leads to a deterioration in the rheological properties of the blood, with the subsequent formation of blood clots in the lumen of blood vessels;
  9. Large fruit. An increase in the size of the fetus is usually caused by the formation of diabetes in a pregnant woman. If the weight of the child exceeds 4 kg, then such a woman is recommended surgery by the type of caesarean section;
  10. Frozen pregnancy. Excess body weight is one of the potential causes of intrauterine death of the fetal egg in the early stages of gestation;
  11. Spontaneous or premature termination of pregnancy.

Another extremely serious complication of obesity during pregnancy is the so-called perinatal mortality. The percentage of occurrence of this complication in overweight women in labor is at least 15%. The main reason for this complication is premature detachment of a normally located placenta. In addition, women with a similar diagnosis often have postpartum hypotonic bleeding, which is caused by a violation of blood coagulation. Such situations, most often, affect pregnant women who have impaired liver synthetic function against the background of overweight. Obese pregnancy itself is a risk. In addition, it is difficult for such women to become pregnant without additional medical help.

In addition to complications from the mother's body, such a serious condition leads to the formation of such consequences on the part of the child's body:

  1. Congenital anomalies in the development of the fetus. Excessive body weight of a pregnant woman is a predisposing factor in the development of such intrauterine anomalies as malformations of the valvular apparatus of the child's heart, as well as defects in the structure of the neural tube, leading to pathologies from the central nervous system;
  2. Chronic diseases of organs and systems, such as pathologies of cardiac activity, autoimmune diseases and diabetes mellitus;
  3. Macrosomia. The development of obesity in pregnant women can cause an increase in the weight of the developing child. In the future, such children are prone to the accumulation of excess body weight.

Management of overweight pregnancy and childbirth

Expectant mothers suffering from obesity need not only specialized medical care, but also constant monitoring of the dynamics of the state of the body. The task of each medical specialist is to monitor the most important indicators of the health of the mother and the developing fetus. The practice of pregnancy management for obesity of varying degrees, includes the following items:

  • Regular fetal echocardiography. In most cases, medical specialists recommend that a pregnant woman perform an ultrasound examination of the baby's heart. This type of medical diagnostic manipulation is available for implementation from 20 to 22 weeks of gestation. The purpose of this study is to exclude pathologies of the valvular apparatus of the baby's heart;
  • Performing a rapid test for gestational diabetes. At the period from 24 to 28 weeks of pregnancy, the patient is recommended to perform the so-called oral glucose tolerance test. For some overweight women, screening testing is recommended early in gestation;
  • Regular visits to the antenatal clinic. Frequent visits to this medical institution have a positive effect on the dynamic assessment of the state of the mother and the developing fetus. If necessary, pregnant women with obesity are prescribed additional ultrasound examinations to assess the growth and weight of the baby.

The tactics of managing pregnancy and childbirth in women with obesity directly depends on such factors as the degree of accumulation of extra pounds, the intensity of labor, the presence or absence of concomitant pathologies of the mother and fetus, as well as the nature of the presentation of the child in the small pelvis. Based on the data obtained, medical specialists evaluate the patient's ability to have a natural delivery. In the absence of such an opportunity, the woman undergoes surgery (caesarean section).

It is widely believed among medical specialists that a pregnant woman suffering from some degree of obesity should be hospitalized 7-14 days before the expected date of birth.

Such a measure is caused by the need to implement measures aimed at preventing the weakness of labor and pregnancy overdose. Such support improves the energy processes in the muscular membrane of the uterus, thereby increasing the biopotentials for physiological contraction.

To achieve a similar result, a 10% calcium chloride solution, estrogens, ascorbic acid and a 40% glucose solution are used. If a woman in labor with obesity has no indications for performing a caesarean section, then during labor, she is recommended to administer painkillers and antispasmodics as often as possible. If there is a problem of weakness of labor activity, then along with such drugs as Oxytocin, the patient is administered Hydrocortisone and Insulin in small doses.

To achieve acid-base balance in the body and prevent pathological acidosis, medical specialists inject a 5% solution of sodium bicarbonate. In addition, a prerequisite is the medical prevention of intraoperative and postoperative bleeding.

Treatment

Complex therapy of obesity during pregnancy consists in increasing the mobilization of fats from the so-called depot, as well as reducing the energy value of food consumed. The practice of so-called therapeutic fasting is strictly prohibited during pregnancy, since these experiments lead to a deterioration in the general condition of the mother, the development of iron deficiency anemia, and the formation of abnormalities in the development of the fetus. Regardless of the degree of accumulation of extra pounds in the body of a pregnant woman, her diet should contain fermented milk products, chicken eggs, meat and fish. These food products have a supply of essential trace elements that ensure the harmonious development and growth of the unborn child.

The key points of a healthy diet for obesity are rationality and balance. Eating should be carried out fractionally, in small portions 5-6 times a day. Compliance with the correct dietary recommendations will restore disturbed metabolic processes, as well as create a negative energy balance. The primary task for the expectant mother is to limit calories by reducing the intake of carbohydrate foods. The optimal amount of calories for a pregnant woman is up to 2500 kcal. The carbohydrate component should be compensated by eating foods such as fresh berries, vegetables, wholemeal bread, and fruits (with the exception of highly allergenic ones). The restrictions include confectionery, berry and fruit jams, honey and fresh pastries. Despite the fact that overweight pregnant women need to limit carbohydrates, a sharp decrease in the amount of carbohydrate food consumed can lead to the transformation of proteins into carbohydrate compounds. Such a process will not benefit the body of the expectant mother.

The fat component of the diet should be compensated by the use of butter and vegetable oils. Products such as margarine, spreads, beef and pork fat should be completely excluded from the diet.

In addition, the body of a pregnant woman must receive the required amount of proteins, since these elements are not only a building material for the whole body, but are also a structural part of hemoglobin. Protein deficiency in the body is one of the main causes of anemia during pregnancy. The protein component is recommended to be drawn from products such as whole milk, low-fat varieties of fish and meat, as well as chicken or quail eggs. Particular attention should be paid to the amount of table salt consumed. Its excess leads to excessive accumulation of fluid in the body, with a subsequent increase in body weight. The daily allowable amount of salt is no more than 5 g.

If the expectant mother observes a balanced diet, her weight gain during the second half of pregnancy does not exceed 300 g every 7 days. For an expectant mother with overweight, the so-called fasting days are useful, which include the use of fermented milk products, fruits and fruit juices. The frequency of fasting days should be no more than once every 7 days. During this day, it is permissible to consume no more than 600 g of cottage cheese with a low percentage of fat content, 1-2 glasses of fat-free kefir and tea without sugar. It is useful to eat fresh and baked apples without added sugar.

In addition to the above dietary recommendations, an obese pregnant woman is recommended to perform therapeutic exercises, the purpose of which is to activate metabolic processes in the body and increase fat utilization. The selection of appropriate exercises and their multiplicity is carried out on an individual basis, taking into account the neglect of the pathological process and the presence of concomitant diseases in a pregnant woman. During the complex therapy of obesity, every expectant mother is recommended to constantly monitor the level of glucose in the blood.

Prevention

If the expectant mother does not want to face the problem of obesity, then she is recommended to follow simple rules that are aimed at maintaining metabolic processes in the body. These rules include:

  • In the case of a hereditary predisposition to gaining excess body weight, every pregnant woman is recommended to follow a rational and balanced diet. Such a diet includes the use of fresh fruits and vegetables, as well as the restriction of pasta, bakery and confectionery. In addition, meals should be divided into 5-6 times;
  • Remedial gymnastics, selected by the attending physician on an individual basis;
  • Timely medical registration in the antenatal clinic. This procedure must be implemented before 12 weeks of gestation;
  • Constant monitoring by a specialist obstetrician-gynecologist;
  • The introduction of a categorical ban on the consumption of alcoholic beverages and smoking.