Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines

Michelle A. Kominiarek; Suneet P. Chauhan

doi:10.1055/s-0035-1567856

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(05): 433-441
DOI: 10.1055/s-0035-1567856

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines

Michelle A. Kominiarek

¹Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Chicago, Illinois

,

Suneet P. Chauhan

²Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas

› Author Affiliations

Abstract

Objective This study aims to compare how national guidelines approach the management of obesity in reproductive age women.

Study Design We conducted a search for national guidelines in the English language on the topic of obesity surrounding the time of a pregnancy. We identified six primary source documents and several secondary source documents from five countries. Each document was then reviewed to identify: (1) statements acknowledging increased health risks related to obesity and reproductive outcomes, (2) recommendations for the management of obesity before, during, or after pregnancy.

Results All guidelines cited an increased risk for miscarriage, birth defects, gestational diabetes, hypertension, fetal growth abnormalities, cesarean sections, difficulty with anesthesia, postpartum hemorrhage, and obesity in offspring. Counseling on the risks of obesity and weight loss before pregnancy were universal recommendations. There were substantial differences in the recommendations pertaining to gestational weight gain goals, nutrient and vitamin supplements, screening for gestational diabetes, and thromboprophylaxis among the guidelines.

Conclusion Stronger evidence from randomized trials is needed to devise consistent recommendations for obese reproductive age women. This research may also assist clinicians in overcoming one of the many obstacles they encounter when providing care to obese women.

Keywords

body mass index - national guidelines - obesity - pregnancy

Full Text

References

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