In our country, according to data from the Ministry of Health (2023 INE Health Survey), around 15% of the adult population lives with obesity. A percentage that the Spanish Society of Cardiology (SEC) raises to 22%. This serious health problem can have consequences for women who want to become pregnant. But also for those who are already pregnant. Susana del Pozo, doctor in Nutrition and Professor of the Department of Nutrition and Food Science at the Complutense University of Madrid, tells us.
Problems caused by obesity when trying to get pregnant
Obesity is associated with a decrease in female fertility, because, in the words of the expert, «it causes hormonal imbalances that alter the secretion of reproductive hormones, as well as the functioning of the hypothalamic-pituitary-ovarian axis. What happens is that «it can affect both the quality of the oocytes and the receptivity of the endometrium.»
In other words, women with obesity more frequently present anovulation and subfertility, which reduces spontaneous ovulation rates and makes pregnancy more difficult. These hormonal alterations also reduce the success of assisted reproduction treatments. For this reason, says del Pozo, “weight loss is considered a fundamental step to improve fertility and increase the chances of achieving a pregnancy.”
Risks caused by obesity during pregnancy
Indeed, obesity during pregnancy poses a significant risk for both the mother and the fetus. In fact, it is associated with complications that can have short- and long-term consequences.
- Maternal health: «Obesity increases the likelihood of developing gestational diabetes, the risk of which increases as body mass index increases before pregnancy, and increases the likelihood of developing type 2 diabetes after pregnancy. It is also associated with an increased risk of preeclampsia and a greater likelihood of complications during childbirth and the postpartum period.» In addition, it is related to spontaneous abortions.
- baby health: “Children of mothers with obesity have a higher risk of congenital anomalies and macrosomia (excessive fetal size), which can make childbirth more difficult and increase the risk of birth injuries.”
It must also be remembered that these babies are more likely to develop obesity, diabetes and cardiovascular diseases, as well as possible alterations in neuropsychological development.
Keys to taking care of the health during pregnancy of a woman with obesity
The doctor in nutrition care is clear in this sense: «Prenatal care is essential to detect and control possible risks during pregnancy. In the case of women who live with obesity, pregnancy can lead to more complications, so it is especially important to have more frequent medical follow-up.»
Del Pozo recommends regular monitoring of weight, blood pressure and blood glucose, following a healthy diet with the help of a dietitian-nutritionist, and engaging in moderate physical activity on a regular basis.
Regarding the usual weight gain during pregnancy, in women living with obesity, the recommended weight gain is less than in women with normal weight, generally being between 5 and 9 kilos, depending on each case. This does not mean following a low-calorie diet, but intake must be adjusted to the excessive weight before pregnancy but providing the necessary calories and nutrients during the pregnancy trimester.
Strategies for a healthy pregnancy with obesity
The specialist advises that a dietician-nutritionist accompany and advise on the diet of these women, carrying out food planning adapted to each case, which allows weight gain appropriate to their situation during pregnancy.
But in general, it aims to:
- Maintain «a varied, balanced, safe and pleasant diet, which includes foods rich in nutrients such as fruits, vegetables, legumes, whole grains and dairy products. Eating should continue to be a pleasure, since pregnancy is not a disease and the diet must adapt to the customs, culture and social environment of each woman»
- The diet should be similar to that of a healthy adult woman, distribute meals throughout the day in several meals and ensure good hydration. The regular consumption of fruits, vegetables and legumes, together with an adequate intake of fiber, fluids and the practice of moderate physical activity, helps prevent frequent problems such as constipation.
- At this stage it is essential to maximize food hygiene and safety. In addition to «opting for simple and healthy preparations such as cooking, steaming or grilling. It is also advisable to take supplements that in each case are recommended by health professionals, such as folic acid or iodine.»
The expert remembers that enjoying a treat is part of a balanced diet, as long as the main objective is to maintain healthy habits.
Particularities in the medical follow-up of the pregnant woman
The recommendation is that the follow-up be personalized for each woman according to her characteristics and that it be carried out by a multidisciplinary team, made up of different health professionals and including a dietitian-nutritionist.
Frequently asked questions
Among the most common doubts raised by pregnant women living with obesity are the following:
Can you lose weight during pregnancy?
«No. It is advisable to control that weight gain is appropriate, limiting it and adjusting it to the woman’s initial weight, because weight loss could harm the health of the fetus.»
What diet is the most recommended if the mother suffers from obesity?
“You should follow a personalized diet supervised by a dietician-nutritionist that includes safe foods with a high amount of nutrients, monitoring appropriate consumption of basic foods such as whole grains, fruits, vegetables, dairy products, fish, eggs, lean meats, legumes, etc.” There is much evidence that adherence to the Mediterranean diet during pregnancy helps control weight and gestational diabetes, as well as the possible complications of obesity.
How does obesity affect childbirth?
Obesity can influence childbirth in different ways. In fact, «in women who live with obesity, a higher percentage of labor inductions is observed compared to the rest of pregnant women. In addition, it can affect the progression of labor, since the uterus has a lower capacity for contraction, it also increases the risk of instrumental deliveries, cesarean sections and premature births,» concludes Susana del Pozo.
The ALDI Council
Choose nutritious foods during pregnancy for your health and that of your baby, such as fruits, vegetables, whole grains, and healthy sources of protein, such as legumes, dairy products, eggs, meat or fish.
Susana del Pozo de la Calle. Assistant Professor Doctor at the Complutense University of Madrid (UCM). Previously, she was Director of Analysis at the Spanish Nutrition Foundation (FEN) between 2007 and 2016. Her main lines of research focus on the assessment of nutritional status, the diet-health relationship and culinary nutrition. He is a member of the UCM research group Nutrition and Gastrointestinal Health (NuSaGa). She is the author of books and book chapters, teaching publications and articles in scientific journals, and has presented communications and posters at scientific conferences. He has participated in projects financed by the European Union, in national public calls, as well as in projects promoted by foundations and private entities.
