Obesity and pregnancy Flashcards
Definition
Obesity is classified using the Body Mass Index (BMI) as follows:
= Class I: BMI 30-34.9
= Class II: BMI 35-39.9
= Class III: BMI ≥40
Typically affects pregnancy through various mechanisms, including:
- Insulin resistance
- Increased levels of pro-inflammatory cytokines
- Changes in vascular function
Epidemiology
Sedentary lifestyle
High-calorie diet
Socioeconomic status
Genetic predisposition
Signs and symptoms
Weight gain and elevated BMI
Diagnosis
FIRST LINE = BMI
Consider =
- OGTT: diagnosis GDM >7.8 mmol/L
= Conducted for all women with obesity at 24-28 weeks
- Lipid profile
Treatment
FIRST LINE:
- Lifestyle modification
- Folic acid: 5mg, at least 1 month pre-conception and during first trimester
SECOND LINE:
- Metformin
Maternal Complications
- Gestational diabetes
- Pre-eclampsia
- Venous thromboembolism
- Caesarean birth
- Postpartum haemorrhage
- Difficulty breastfeeding
Fetal complications
Congenital anomolies: spina bifida
Still birth
Prematurity
Macrosomia
Childhood obesity