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Feb. 25, 2002 -- Most women know that taking vitamins and avoiding drugs like caffeine and alcohol can help assure a healthy pregnancy. But a new report warns many more may not be aware that simply losing weight and being in shape before pregnancy could be just as important to the health of both baby and mom.
A new report presented today by the March of Dimes Task Force on Nutrition and Optimal Human Development shows women who are overweight or obese are 30% to 40% more likely to deliver a baby with a major birth defect such as those that affect the brain, heart, and digestive system.
"It's an area where weight matters more than we think," says Richard Deckelbaum, MD, chairman of the task force and director of the Institute of Human Nutrition at Columbia University. "People don't really understand the effect on the babies."
He says it's harder to get pregnant when you're overweight, and then if you do get pregnant, the risk of complications during pregnancy and problems for the baby increase dramatically.
Overweight was defined as being 10-15% heavier than recommended for a woman's height, or having a body mass index or BMI (a measurement of weight in relation to height) of 25 to 30. Obese was having a BMI of 30 or more. A BMI of 18.5 to 25 is generally considered to be healthy, which equates to a weight of between 110 to 144 pounds for a 5-foot-4-inch woman of average build.
The report shows overweight or obese women are at increased risk of having complications during pregnancy such as gestational diabetes, pre-eclampsia or eclampsia (high blood pressure during pregnancy), and hospitalization.
"The risk of the mother being hospitalized during pregnancy goes up four times if she's overweight. If her BMI is over 35, the risk goes up by six to seven times," says Deckelbaum. The risk of stillbirth or death in the first week after birth, known as perinatal mortality, also increases as maternal BMI increases.
Deckelbaum says most doctors -- as well as their patients -- are unaware of this connection even though the risks are well documented by research. He says the public seems to understand the importance of other things women can do to ensure a healthy pregnancy and baby, such as folic acid supplementation, but the message about being in shape before pregnancy has been lost.
In light of the U.S. Surgeon General's declaration that the country is facing an "epidemic of obesity," experts agree that we're going to be seeing more pregnancy problems associated with maternal overweight and obesity. According to the task force, the percentage of women aged 20 to 29 who are obese has more than doubled from 7% in 1960-62 to 17% in 1988-94.
"It's an issue that's going to grow in importance," says Martha Werler, ScD, associate professor in the school of public health at Boston University. Werler was the author of a 1996 study, published in the Journal of the American Medical Association, that found women who were overweight before pregnancy were more likely to have children with neural tube defects, including spina bifida -- a condition that can paralyze the legs.
"There are definitely pregnancy complications that come with obesity," says Werler.
Although it's not recommended that women try to rapidly lose weight through crash diets, experts say it is important for women to try to achieve a healthy weight through sensible diet and exercise before having a baby.