Obesity during pregnancy is associated with all of the following except..Introduction:According to recent global WHO estimates for 2014 more than 1900 million adults aged 18 or over were overweight, of which more than 600 million were obese and where approximately 40% were overweight and obese women.
obesity during pregnancy is associated with all of the following except
Obesity in pregnancy is a conflict for public health, because it increases obstetric and neonatal risks. Overweight in women of childbearing age has doubled in the last 30 years, and the number of pregnant women with obesity is also increasing. Overweight and maternal obesity are associated with multiple complications, mainly hypertensive disorders and Gestational Diabetes, in addition to others such as spontaneous abortion, preterm birth, intrauterine fetal death, fetal macrosomia, labor alterations and a higher cesarean rate.
Objective: To describe the maternal complications associated with overweight and obesity during pregnancy and to identify the most adequate data on a healthy life and prevention of overweight and obesity in pregnant women.
Methodology: Literature from Google Academic, MEDLINE, Pubmed, Cochrane and Scielo databases sources published between 2010 and 2016 in English and Spanish was reviewed.
Conclusion: Gestational Diabetes and hypertensive disorders are the main complications related to maternal overweight and obesity.
According to recent global estimates, the World Health Organization (WHO) reveals data in 2014, where more than 1,900 million adults aged 18 or over were overweight, of which more than 600 million were obese where 40% were women overweight and 15% were obese [ 1 ].
The nutritional status of women before and during pregnancy is one of the determinants of the risks of maternal mortality and of the possibilities of development of the fetus, intrauterine mortality, duration of pregnancy and complications of childbirth [ 2 ].
In the years 2011-2012 a study conducted by the National Survey of Demography and Health (ENDESA) at the national level concluded that the problem of overweight and obesity has been increasing from 47% (ENDESA 2005-2006) to 51%. 51% percent of women of childbearing age are overweight or obese and in this group 29% correspond to overweight women and 22% to obese women. With regard to the age of women, the highest percentages of overweight and obesity are observed among women aged 30 or older with 68% compared to 21% of adolescents aged 15-19 years [ 2 ].
Obesity leads to high-risk conditions during pregnancy, such as miscarriage, gestational diabetes, gestational hypertension, preeclampsia, preterm birth with medical indication, labor changes and a higher rate of cesarean delivery, including certain types of cancer [ 3 , 4 ]
In this article, a review of the literature on the main maternal complications associated with overweight and obesity during pregnancy was conducted, in order to help identify the most appropriate data on a healthy life and prevention of overweight and obesity in pregnant women.
Methodology: We reviewed the literature sources of Google Scholar, MEDLINE, Pubmed, Cochrane and Scielo databases. The inclusion criteria were: Articles published between 2010 and 2016 in English and Spanish, articles of original type, protocols, international management guides and national and international statistical electronic documents.
Overweight and Obesity in Pregnancy
Physiologically, there are substances that are related by inhibiting or stimulating hunger and satiety, such as leptin, ghrelin and neuropeptide Y [ 5 ]. The body mass index (BMI) is a parameter that is used for the diagnosis of overweight and obesity with validity throughout the world, being the most used in epidemiological studies [ 6 ].
Obesity is classified according to the WHO in: Normo weight (BMI of 18.5-24.9), excess weight (BMI> 25 kg / m 2 ), overweight or pre-obese (BMI 25-29.9 kg / m 2 ), obesity grade I or moderate (BMI 30-34.9 kg / m 2 ), severe grade II obesity (BMI of 35-39.9 kg / m 2 ), obesity grade III or morbid (BMI> 40 kg / m 2 ) [ 6 ].
Obesity in pregnancy is a conflict for public health, since it increases obstetric and neonatal risks [ 7 ] increases the risk of presenting diseases and complications during pregnancy and childbirth [ 8 ] such as: Gestational diabetes, pre-eclampsia, non-alcoholic liver diseases,
disorders of coagulation (thromboembolism) and oligo / polyhydramnios and in the fetus the disorders include: Fetal macrosomia, respiratory distress syndrome and products with low weight for gestational age, prematurity, genetic malformations and increased risk of fetal death [ 9 , 10 ].
In a study conducted in the city of Asunción, Paraguay, among pregnant women who attended antenatal care, it was found that one out of every 12 women studied began their pregnancy with some degree of obesity [ 8 ].
The number of pregnant women with obesity is also increased, coinciding with an advanced maternal age at the time of pregnancy [ 9 ]. Overweight in women of childbearing age has doubled in the last 30 years. According to the national perinatology institute of Mexico, a greater percentage of 80% of overweight or obese pregnant women is observed [ 10 ].
In a study carried out in a Cuban gynecoobstetric university hospital, it was observed that the puerperium is the time of greatest number of complications in obese pregnant women and more transcendental with obstetric morbidity, highlighting the following complications: anemia, hypertensive disorders, obstetric hysterectomies, reinterventions, admission to the intensive care unit, eviscerations, infections and eclampsia [ 8 ].
Multiparity, low calcium intake before and during pregnancy, chronic stress, extreme maternal ages [ 8 ], habits and a lower level of education are considered predisposing factors for a greater weight gain in pregnancy [ 9 ]. The weight gained in pregnancy is determined by several elements that include physiological, family, social and nutritional [ 10 ].
Obesity increases the possibility of complications in pregnancy and subsequent to it, among the complications that we can mention are liver diseases, embolic vein thromboembolic disorders (more frequent in the 2nd trimester) [ 11 ] pelvic floor disorders [ 12 ], diabetes gestational, hypertensive disease of pregnancy, dystocias, fetal macrosomia among other future complications for maternal and baby health [ 13 ].