Advanced Maternal Weight
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Maternal obesity has emerged as a major public health problem in developed, as well as developing countries and the incidence at the start of pregnancy is increasing worldwide. Pregnancy with obesity is high risk, and it causes substantial feto-maternal morbidity and mortality. Obesity during pregnancy is defined as a Body Mass Index (BMI) of 30 kg/m2 or more calculated using the height and weight measured at the first antenatal consultation. Pre-pregnancy BMI defines their commended individual gestational weight gain and the Institute of Medicine recently modified their guidelines in regards to healthy weight gain during pregnancy. In India, more than 15% of women are either overweight or obese whereas only one tenth of men report this health condition. The risk factors are overweight or obese during childhood, increased intake of refined carbohydrates, decreased intake of fresh fruits and vegetables and physical activity, low socioeconomic status, urbanization and an unhealthy, energy-dense diet, as well as changing lifestyles, are root causes contributing to obesity. Obesity caused by multifactorial interactions between genetic and environmental factors. Obese women successful at conceiving is at an increased risk for several pregnancy-related complications like increased risk of gestational diabetes, hypertensive disorders, preeclampsia, blood clots, infections, and preterm delivery. Even sensitive and mindful psychological approach is necessary and mandatory as a part of management. Obese mothers are at higher risk for perinatal complications including stillbirth, neonatal death, low Apgar scores, fetal distress, macrosomia, presence of meconium, shoulder dystocia, neural tube defects such as spinabifida and congenital anomalies. Postpartum weight retention leads to postpartum maternal obesity and greater increases in body weight before subsequent pregnancies and contributes to intergenerational cycle of obesity. Variety of health risks for the fetus and infant occurs more likely to be large for gestational age. Maternal obesity can be successfully managed by regular physical activity, dietary supplementation, calorie restriction, and at last pharmacological intervention.
Advanced Maternal Age, Maternal Obesity, Obesity in pregnancy, Gestational weight gain, Over weight in pregnancy.