Should Pregnant Overweight Women Worry?

QUESTION: I'm pregnant and fat. What do I need to worry about?
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ANSWER: Overweight women experience more problems during pregnancy than women
of normal weight, and women who are unable to return to their pre-pregnant
weight following delivery may find that having additional children will make
their weight problem worse.
Generally, you are considered overweight if you weighed more than 200
pounds before you were pregnant or 250 or more during pregnancy.
One of the most common complications in overweight women is hypertension
(high blood pressure), which can cause slow growth of the fetus, and may even
result in a stillbirth. One type of hypertension associated with pregnancy is
most common if it is the first pregnancy, and it is more likely to occur if
you are overweight. Another possible problem is gestational diabetes, which
is more likely to occur in pregnant women who are overweight.
Overweight women are also at higher risk of having abnormalities during
labor, such as those necessitating cesarean section, and they are also at
greater risk for postoperative complications.
There is a much lower risk of premature delivery in overweight women than
in normal weight women, but a higher rate of postdate deliveries--deliveries
occurring after 42 weeks gestation.
It is important for you to get early prenatal care so that any
complications can be detected and managed as quickly as possible. Your doctor
probably will not want you to try to lose or maintain your weight during
pregnancy, since weight gain during pregnancy is normal and important to your
baby's development.
Although there are potential complications associated with overweight
pregnancy, most obese women have normal pregnancies and healthy babies