Difficult Delivery, Diabetes Risk: Why Is Maternal Obesity So Concerning?

As health professionals sound an alarm about maternal obesity, FIT reached out to experts to understand more.

In 2014, there were 38.9 million overweight and obese pregnant women globally. In the same year, India accounted for the largest number of overweight and obese pregnant women – at 11.1 percent or 4.3 million.

These are statistics from a decade ago. The data has not improved over the years. In 2022, there were 4.4 crore obese women in India – a significant chunk of them struggling with maternal obesity. 

As health professionals sound an alarm about maternal obesity, this forewarning from a 2008 study, published in Obstetrics & Gynecology, still holds true:

“Not only does maternal obesity affect the woman, but it also impacts the health of the child, leading to increased childhood obesity and diabetes.”

FIT reached out to experts – Dr Niti Kautish, Director, Obstetrics and Gynaecology, Fortis Hospital, Faridabad, and Dr Aruna Kalra, Director, Obstetrics and Gynaecology, CK Birla Hospital, Gurugram – to understand how maternal obesity impacts the health of both the mother and the baby.

Why Is Maternal Obesity Risky?

Let’s start with the very basic but important question – why is maternal obesity risky?

Dr Niti Kautish, speaking to FIT, explains, “If the mother is obese, the internal environment of the uterus gets impacted. There is a high risk of gestational diabetes, hypertension, thyroid, and thromboembolism.”

Dr Aruna Kalra agrees. She adds that stabilising the to-be-mother’s vitals can also be a challenge.

There is a higher risk of gestational diabetes and blood pressure levels being higher than the standard.

Not just that, the woman’s mobility might also be restricted and they could have trouble sleeping – experiencing sleep apnea.

Can it affect the baby's health too? Unfortunately, yes. Dr Kautish says that obese mothers can pass the condition genetically to the foetus. 

“If the obese mother has gestational diabetes, there are higher chances that the baby will be obese in-utero and be born overweight – likely weighing more than four kgs. There are higher chances of macrosomia (a life-threatening condition) in the pregnancy as well.”

Dr Niti Kautish

In fact, a 2021 study, published in BMC Pregnancy and Childbirth, had stated, “Maternal obesity seems to influence birth weight more than gestational diabetes.”

At the time of birth, the baby could also be prone to respiratory distress syndrome, other respiratory problems like asthma, breathing complications, and congenital disorders, adds Dr Kalra. 

Later in its life, the baby has a higher risk of developing:

• Diabetes

• Hypertension

• Obesity

• Comorbid diseases

"Babies born from maternal obesity are prone to hypoglycemia and respiratory distress."

Dr Niti Kautish

Delivery Becomes Even More Challenging Due to Obesity

However, it’s a misconception that the challenges only come later. Dr Kautish explains to FIT that even delivering the baby and labour itself can become more complicated due to obesity.

Dr Kalra, adding to Dr Kautish’s point, says, “The excess fat in the uterus and the pelvic bones can cause obstruction during labour, leading to a difficult vaginal delivery.”

“A vaginal delivery for obese women comes with a high risk of postpartum haemorrhage. So usually in these cases, we have to prepare for instrumental or caesarean section delivery too. That too has risks attached – bleeding, infection, longer time for wound healing because of excess fat, etc.”

Dr Niti Kautish

So are there any precautions or preventive measures that pregnant women, who are also obese, should keep in mind?

‘Lose Weight, Keep Vitals in Check’: Take These Precautions

Dr Kautish tells FIT, “Ideally if an obese patient comes in, we advise them to lose weight before trying to conceive. But if they’re already pregnant, then our job becomes optimising the mother and baby’s health.”

Dr Kalra agrees. This is what both of them suggest:

While normally women gain 10-12 kgs during pregnancy, women who are clinically obese must aim to keep their weight in check. Doctors advise that they try to avoid putting on any weight during the first six months of pregnancy.

Even in the last three months, the pregnant women must be careful not to gain more than 5-6 kgs of weight.

• Follow a low calorie diet

• Exercise regularly

• Stay physically active

• Consult your doctor regularly and go for prenatal checkups

• Keep your vitals – such as blood pressure and blood glucose levels – under control

While these are all precautionary measures for pregnant obese women, Dr Kautish goes on to add, “Since there are high risks associated for the infant as well, after the delivery, we also tell new mothers to monitor the sugar levels and respiration of the infant."

In the longer run as well, Dr Kautish advises that the child strictly follow a healthy and active lifestyle once they turn 3-4 years old to avoid any diseases or complications.

She says, “As the kid grows up, their diet, fat restriction, and physical activity should also be paid attention to.”

While these are individual measures, more of course needs to be done at a policy level and more research needs to go into the socioeconomic aspects of obesity.

A 2022 study published in BMC Women’s Health had recommended “an urgent need of interventions catering to urban women belonging to higher socio-economic status which can reduce the risks of health consequences due to overweight and obesity.”

(All of April, Quint FIT is decoding the alarming rise in obesity in India and the various health risks associated with it. Follow our full coverage here.)