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Obesity and Pregnancy
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Precautions for pregnant woman

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Before becoming pregnant. Women with a BMI of 25 or over who want to become pregnant should undergo a weight reduction programme (ideally, to achieve a BMI less than 25) through adequate nutrition and physical exercise. The patient must be informed about the increased risk of complications during pregnancy.

During pregnancy. Pregnant woman must calculate their BMI using their weight before they became pregnant. A weight gain considered adequate can be calculated based on the BMI, while bearing in mind at all times that she should try to maintain adequate lifestyle habits, in relation to food and performing physical exercise, rather than focusing on a certain weight gain. The diet must be normocaloric, normoproteic and not hyposodic. Lipid-lowering drugs (e.g. topiramate and orlistat) are contraindicated.

Is any type of supplement recommended?

Taking high doses of folic acid (5 mg/day) is recommended from 1 month before conception until the 12th week of pregnancy, as it reduces the probability of the newborn developing neural tube defects. Likewise, it is recommended to take a supplement of 10 μg of vitamin D throughout pregnancy and breastfeeding. Otherwise, supplement recommendations are no different from a normal pregnancy.

Is physical exercise recommended?

Moderate physical exercise is recommended for at least 20-30 minutes a day most days of the week (at least 150 minutes a week). There are some, but few, contraindications for aerobic physical exercise during pregnancy. If in doubt, consult your reference obstetrician.

Intrapartum care

The control of intrapartum foetal well-being can be made more difficult the higher the mother’s BMI; sometimes, therefore, internal monitoring of the baby’s heart rate and maternal uterine dynamics is required. Also, the success of a vaginal delivery after a previous caesarean section is impaired, increasing the probability that the delivery ends up as a caesarean section.

Postpartum

It should be taken into account that there is a higher rate of failure in milk production for breastfeeding, due partly to delayed lactogenesis. Likewise, there are sociocultural and psychological factors that influence the lower success rate of breastfeeding. There are breastfeeding workshops to help start breastfeeding and maintain it over time if you wish.

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The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.

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