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Tuesday, October 23, 2012

Planning a Pregnancy: Diet First

The first reason to lose weight when pregnancy planning, if you are obese is that obesity is associated with subfertility, as well as miscarriages. growth disorders for the fetus, birthing problems, diabetes and hypertension, just to name a few of the issues. You can find a lot about risk factors for birth defects on March of Dimes site, but you may have to ask your gyno about your overall fitness to become pregnant as obestity for one issue is not covered there. It is not known exactly why obese patients have trouble conceiving. Women who are obese and have polycystic ovarian disease (PCOS) are less likely to ovulate and conceive. But women who are obese without PCOS are also less likely to ovulate than the average person due to increased insulin resistance (your body not responding to insulin as normal women do), and that treating this will increase fertility.  Miscarriages also called Spontaneous abortions (SAB) and recurrent SAB are also associated with obesity. We don't know if this is more related to insulin and sugar levels, how you process carbohydrates, or if in fact it could be related to the level of inflammation in your blood. And those women who also have diabetes secondary to obesity are particularly prone to risk. In some states the diabetes rate is already over 10%. New criteria for the diagnosis of diabetes in pregnancy likely is going to push the rate of diabetes to over 20% of all pregnancies. Those states right now that have diabetes rates of over 10% are Texas, Alabama, Tennessee, Georgia and West Virginia. And if you do not lose weight we therefore will see that getting pregnant when you are obese puts both mom and baby at risk. When you are obese and pregnant your body doesn't pass nutrients to the baby as effectively.  Moms who are obese will preferentially put on midline fat in the last trimester, and that this is not necessarily beneficial for the developing fetus. Hypertension and diabetes as well as labor abnormalities are associated with obesity during pregnancy. Obese moms are also at more risk to havepre-eclampsia (PEC) and to have the most severe forms of PEC.  Stillbirth rates are increased 2.6 fold in women with obesity.  If an obese woman receives surgery, such as a C-section, it is more likely she will have a complication of that surgery, including increased risks with anesthesia and/or bleeding and infection. So see your gyno first before planning pregnancy to establish a pregnancy health plan. We want to know about your sugar processing, your nutrition, your overall fitness as well as whether you are overweight. There maybe ways we can, through blood testing, find out if you are fit for your weight as well as ready for a pregnancy. If you can effectively post pone pregnancy until you have normalized your weight, or at least gotten closer to a normal weight, you will likely have a much healthier and happier pregnancy. If you develop hypertension in pregnancy, there are new guidelines as to how to minimize the effects on the pregnancy, but it is still important to try to become healthy, before you become pregnant.

1 comment:

  1. Obesity patients will have less chances of getting a pregnancy, if they are pregnant also they will face lot of problems, its better to loose weight before getting a pregnancy

    Pregnancy Week by Week

    ReplyDelete

Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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