Women who are significantly obese can reduce their risk of pregnancy complications, including gestational diabetes and pre-eclampsia, by losing just a small amount of weight, a new study from Sydney researchers suggests.
The report comes amid concerns that not enough is being done to address obesity during the pandemic.
Researchers from Northern Sydney Local Health District compared patient records from more than 2500 obese mothers who gave birth over a five-year period, adjusting for demographic factors such as age.
Emma MacCarthy, who recently lost more than 50kg, says she would have wanted to know about the risks of falling pregnant while morbidly obese.Credit:Jessica Hromas
While previous studies have shown how women with obesity have a higher risk of complications than those within a healthy weight range, the new research, published in Frontiers in Endocrinology this week, showed an increased risk for women with class III obesity (formerly known as morbid obesity and defined as a BMI of 40 or higher) compared to those with class I (a BMI of 30 to 34.9).
Those with class III obesity had more than double the risk of developing pre-eclampsia, a condition characterised by extremely high blood pressure in pregnancy, than those with class I (6.2 per cent compared to 2.8 per cent).
They were also more likely to develop gestational diabetes (28 per cent of class III mothers compared to 21 per cent in class I) and require a caesarean delivery (54 per cent compared to 40 per cent, only slightly above the state average of 37 per cent).
According to NSW Health’s most recent Mother and Babies report, released earlier this year, 15 per cent of women who gave birth in 2020 were obese.
Rates ranged from fewer than 9 per cent of mothers in the Sydney, Northern Sydney and South Eastern Sydney local health districts to more than 26 per cent in the state’s far west and more than 20 per cent in the Nepean Blue Mountains, Hunter New England, Murrumbidgee and Western NSW districts.
Endocrinologist Associate Professor Sarah Glastras, who led the study, said she hoped the findings encouraged women living with obesity to think about reducing their weight before trying to fall pregnant.
“You’re not only putting your health at risk, but this research shows that you’re putting a lot of risk on the unborn child as well,” she said. “We, as women, need to be fully informed, so we can make the very best choices before planning to have a child.”
After two years of pandemic restrictions, Australia could be facing an obesity wake-up call, said Associate Professor Sof Andrikopoulos, CEO of the Australian Diabetes Society and head of the biology and metabolism research group at the University of Melbourne.
“The lockdowns have increased people staying at home, eating less well and not exercising as much, and people haven’t been to the GP where weight might be monitored,” he said, noting bariatric surgery had also been disrupted by elective surgery restrictions.
Dr Andrikopoulos said the study, which he was not involved with, showed similar results to other obesity-related conditions.
“If you’re obese, any weight loss is going to have positive outcomes for chronic conditions,” he said.
Dr Glastras said, while it was “possibly too early” to understand the impact of the pandemic on obesity rates, working from home had allowed some people to exercise more and spend more time preparing healthy meals.
However, she expected school and university students – moving to learning from home and losing access to recreational activities such as organised sports – had been adversely affected.
“It’s been particularly impactful on the lifestyle of younger people, and they are our reproductive future.”
Emma MacCarthy was more than 50 kg above a healthy weight when she fell pregnant in 2017. She was not aware it would impact the kind of pregnancy she had.
The mother, now 45, from north-west Sydney was diagnosed with gestational diabetes, and her pregnancy was treated as high-risk. While she gave birth to a healthy son, a subsequent pregnancy ended in miscarriage.
“Having a baby seemed like the most natural and happy thing in the world,” she said. “I was definitely naive to the risk – oblivious to it – and very, very lucky my doctors were not.”
Three years after giving birth, it was the pandemic that spurred Ms MacCarthy to change her diet and exercise patterns, bringing her weight to a healthy range over 12 months.
“COVID was starting and I realised: I’ve got two young children and, if I get it, I could be in some serious trouble. I need to do something about this.”
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