obesity and pregnancy - finished cards Flashcards
(44 cards)
what is the definition of obesity in pregnancy?
Obesity in pregnancy is usually defined as a Body Mass Index (BMI) of 30 kg/m2 or more at the first antenatal consultation.
how do you work out the BMI?
BMI: Dividing a person’s weight in kilograms by the square of their height in metres (kg/m2)
what are the classes of obesity?
BMI 30.0–34.9 (Class I);
BMI 35.0–39.9 (Class 2);
BMI 40 and over (Class 3 or morbid obesity)
what are the risks of obesity?
Type 2 Diabetes Insulin resistance Hypertension Dyslipidemia Sleep apnoea Gall bladder disease Coronary heart disease Osteoarthritis Cancer – colon, breast, endoemtrium PCOS Pregnancy related complications Anaesthetic risk
what are the trends of obesity in the UK between 1993-2010
Increase in the prevalence of obesity (BMI at least 30 kg/m2) amongst women of childbearing age (16 to 44 years).
is the prevalence of obesity rising in the UK?
Rising from 9–10% in the early 1990s to 16–19% in the 2000s (21% of antenatal population are obese) BMI ≥35 :4.99%. BMI ≥40 (morbid obesity): 2.01% BMI ≥50 (super-morbid obesity): 0.19%
What is the prevalence of obesity in the world?
International studies show a prevalence of maternal obesity ranging from 1.8% to 25.3% across countries (using the WHO definition of obesity of BMI of at least 30kg/m2)
300 million worldwide
(world population 7.5 Billion, UK – 66 million)
what is the cause of obesity?
Energy intake is greater than energy expenditure, resulting in the accumulation of excess body fat.
Simple equation…when you eat more than you use..it is stored in your body as “fat
Biology: the influence of genetics and ill health
Lack of physical activity
Societal influences: the impact of society, for example the influence of the media, peer pressure or culture;
Individual psychology: psychological drive for particular foods
what amount of exercise is reccomended per week?
The Department of Health recommends that adults do at least 150 minutes (two-and-a-half hours) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.
how man calories should people eat?
The average physically active man needs about 2,500 calories a day to maintain a healthy weight,
Average physically active woman needs about 2,000 calories a day.
what can contribute to a poor diet?
eating large amounts of processed or fast food drinking too muchalcohol eating out a lot eating larger portions than you need drinking too many sugary drinks comfort eating
do genetics have involvement with obesity?
Some people claimthere’s no point trying to lose weight because “it runs in my family” or “it’s in my genes”.
While there are some rare genetic conditions that can cause obesity, such asPrader-Willi syndrome, there’s no reason why most people can’t lose weight.
medical reasons for gaining weight?
anunderactive thyroid gland
Cushing’s syndrome
corticosteroids,
Antidepressants and medicines forschizophrenia–can contribute to weight
what portions of food should be on your plate
1/3 fruit/veg
1/3 carbs
1/3 small amount of diet, protein, and a small amount of fats
what are the maternal risks of obesity?
GDM Preeclampsia Thromboembolism dysfunctional labour Higher caesarean section rates Higher risk of post partum haemorrhage wound infections Stay in hospital for more days lower breastfeeding rate
obesity may be a risk factor for maternal death
what are the long term risks of obesity for the health of the mother?
Women who develop pre-eclampsia – heightened risk of cardiovascular disease
Women who develop GDM – seven fold risk of developing type 2 diabetes
what risks does maternal obesity have on the fetus
miscarriage
congenital anomalies
stillbirth
neonatal death
Prematurity
Macrosomia, LGA : shoulder dystocia and brachial plexus injury
Hypoglycaemia, hyperbilirubinaemia and respiratory distress syndrome
what are the risks of maternal obesity for the child?
Obesity
Cardiovascular dysfunction : higher offspring blood pressure
Increased risk of diabetes
Cognitive and behaviour disorders : ADHD, eating disorders and psychotic disorders
is there a relationship between maternal and childhood obesity?
There is a significant relationship between maternal obesity, macrosomia, and the subsequent development of childhood and adult obesity in their offspring .
Maternal obesity and weight gain during pregnancy are related to higher BMI in childhood and subsequent obesity in adulthood.
what is obesity in pregnancy associated with?
Peripheral and hepatic insulin resistance
Increase in metabolic fuels, glucose, lipids, leptins and aminoacids
Inflammatory state
Altered adipocyte function
Increased adiposite size
Increased mRNA expression of genes involved in adipocyte differentiation.
what is the epigenetic mechanism of obesity in pregnancy?
Maternal over-nutririon and obesity leads to long term modification of specific fetal genes and persistently altered gene expression and altered organ function
what is pederson’s hypothesis
obese mum will have more glucose in the body, that glucose will go to the baby, so the baby produces for insulin from pancreas, which is stored in liver.
this leads to fetal growth
what should obese woman take before pregnancy?
5mg folic acid supplementation daily, starting at least one month before conception and continuing during the first trimester of pregnancy
what are the NICE guidelines for preparing for pregnancy:
woman with BMI 30 or more
Provide information about health benefits of losing weight
Help women with BMI 30 or more to reduce weight before becoming pregnant – at least 5- 10% of weight
Offer weight loss programme – diet and physical activity
Pre-cenception vitamins – folic acid
