Obesity and Fertility

Obesity and birth defects

A recent study by researchers from the University of Texas covering 5 years and over 15,000 women published in August 2007 revealed that obese women are more likely to have babies with birth defects. The identified defects included spina bifida, heart defects, genital and bowel abnormalities and small or missing digits, arms or legs. It is not clear yet whether this is an indirect correlation but it is a another worrying finding.

Pregnancy Issues

When an obese woman conceives successfully, she is already at some disadvantage by virtue of her weight. Excessive body weight is associated with increased risk of almost all the major pregnancy complications including pregnancy-induced hypertension (pre-eclampsia), gestational diabetes and cesarean section. The latter, in-turn, means they are at an increased risk of anaesthetic complications, post-delivery morbidity including infection and thrombosis. Moreover, the routine screening and diagnostic imaging investigations (ultrasound) are much more difficult to do and results are often poor with the inherent risk of missing some significant findings.

How the baby fares

The baby born to an obese woman also fares less well comparatively: There is:

Ø Increased risk of a large baby with the attendant risk of requiring emergency cesarean section, instrumental delivery, a difficult birth and birth trauma

Ø Increased risk of requiring admission in a special care baby unit

Ø Increased risk of death soon after birth (neonatal death)

Ø Obesity is an independent risk factor for stillbirth with some studies showing that the risk is increased two-fold compared to the general average.

Ø The long-term is also less rosy. These babies are also at increased risk of obesity during their adulthood.

In an Ideal World...

It is clearly the case that maternal obesity is an adverse factor when it comes to fertility. Problems encompass the entire process from the attempt to conceive, through pregnancy and well into the post-partum period. Whilst it is true that many obese women will and do navigate the process unscathed, the risks are considerable.

Trying to lose weight before embarking on a pregnancy is a noble quest, the rewards of which are far-reaching. In fact, well beyond a successful delivery of a healthy baby. Of course it is not easy but few truly good things in life are.

Next Section: Phantom Pregnancy