Obesity and pregnancy

Question 1

Definition

Answer 1

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

Question 2

Epidemiology

Answer 2

Sedentary lifestyle
High-calorie diet
Socioeconomic status
Genetic predisposition

Question 3

Signs and symptoms

Answer 3

Weight gain and elevated BMI

Question 4

Diagnosis

Answer 4

FIRST LINE = BMI
Consider =
- OGTT: diagnosis GDM >7.8 mmol/L
= Conducted for all women with obesity at 24-28 weeks
- Lipid profile

Question 5

Treatment

Answer 5

FIRST LINE:
- Lifestyle modification
- Folic acid: 5mg, at least 1 month pre-conception and during first trimester
SECOND LINE:
- Metformin

Question 6

Maternal Complications

Answer 6

• Gestational diabetes
• Pre-eclampsia
• Venous thromboembolism
• Caesarean birth
• Postpartum haemorrhage
• Difficulty breastfeeding

Question 7

Fetal complications

Answer 7

Congenital anomolies: spina bifida
Still birth
Prematurity
Macrosomia
Childhood obesity