Obesity during pregnancy raises stillbirth risk
April 15th, 2014
04:58 PM ET

Obesity during pregnancy raises stillbirth risk

Pregnant women who are obese or overweight have an increased risk of delivering a stillborn baby, according to a new study published Tuesday in the Journal of the American Medical Association.

Researchers looked at 38 studies to better understand the potential risks to an unborn child in relation to its mother's body mass index. They found even a modest increase in an obese pregnant woman's weight is linked to an increased risk of fetal death, stillbirth and infant death.

The highest risk was in women with a BMI over 40 (30 is considered obese). These women were two to three times more likely to experience complications. Even women with a BMI over 25 (which is considered overweight) were found to experience increased complications.

"We found weak, but statistically significant increases in risk even within what is considered the normal ranges of BMI," lead study author Dagfinn Aune said in an e-mail. "For example, the relative risk of stillbirth, perinatal and infant death increased by 20%, 11% and 10% already at a BMI of 25 compared with a BMI of 20, however, the really strong associations were observed among women who were either obese or severely obese who had up to two- to three-fold increases in the risk compared to lean women."

While the risk is increased for women with higher BMIs, he said, the absolute risk is low - meaning it's uncommon.

But "it is quite devastating for the parents it happens to," he said. "I think at least when you get into the obese or severely obese range there is reason for concern. In addition, overweight and obesity is associated with increased risk of many other pregnancy complications, so when you look at the total picture it's not trivial."

Women need to be at their optimum health before deciding to have a baby, said Dr. Jeanne A. Conry, president of the American College of Obstetricians and Gynecologists.

"Healthy lifestyle is critical. Eating healthy and getting 30 minutes of exercise every day are among the most important choices a woman can make. Fifty percent of pregnancies are unplanned, so a woman who is not fit and not using contraception places her infant and herself at risk," Conry said.

The study findings were not a surprise, Conry said - obesity is already known to be associated with complications that can lead to an unhealthy fetus.

"A higher risk of birth defects is seen in women who are obese, and some of these defects may not be compatible with life, or may result in an infant that is compromised," she said. "Obese women have a much higher incidence of diabetes and of hypertension, and such medical problems may lead to early delivery that results in the loss of an infant."

Conry suggests women engage in "preconception planning" and decide what their reproductive goals are for the year to ensure a healthy mom and baby. She recommends women who aren't ready to have a baby use contraception.

And when a woman decides she wants to have a baby, Conry said, she "needs to be close to her ideal body weight, needs to be exercising, needs to have blood pressure and blood sugar in good control, and should not be on any medications that can cause birth defects."

Biological mechanisms could help explain the association between increasing maternal BMI and risk of fetal and infant death, the study suggests.

Higher BMIs are also associated with increased risk of other pregnancy complications, Aune said, such as "gestational diabetes, preeclampsia, gestational hypertension, macrosomia (oversized fetus) and congenital anomalies." Those can all lead to a higher risk of stillbirths or infant deaths.

"One study has suggested that obstetric conditions and placental abnormalities may explain approximately half of all stillbirths," Aune said. "It has also been suggested that thinner women may be better at recognizing decreased fetal movements, which may precede fetal deaths."

soundoff (27 Responses)
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    April 15, 2014 at 21:04 | Report abuse | Reply
    • laura

      Did we forget to take our medication this morning????

      April 17, 2014 at 07:37 | Report abuse |
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  3. Jason

    That is sad. We need to make sure everyone starts getting healthy. This is not a risk we need to carry with us.

    April 16, 2014 at 09:31 | Report abuse | Reply
  4. vixenvarsity

    Interesting. I suffered from 2 stillbirths 2 years apart. 2004 and 2006, both boys. 6.5 months placenta abruption and 8.5 umbilical wrapped around his neck. I am "obese" as they call it. I've given up on trying, I was tired of burying my children.

    April 16, 2014 at 12:37 | Report abuse | Reply
    • Queen

      Have you started a healthy diet or tried to get help? Sorry about your losses very sad,

      April 16, 2014 at 12:46 | Report abuse |
    • Ruby

      Dear Vixenvarsity, I am sorry to read about the loss of your babies. You are an incredibly strong woman to have experienced such sorrow in your life and I wish you peace. Have you ever received a medical diagnosis other than obesity for the stillbirths?

      April 16, 2014 at 13:02 | Report abuse |
    • cali girl

      I am so sorry to hear your loss. There are no words to describe the feeling of losing a child.

      April 16, 2014 at 18:10 | Report abuse |
  5. Queen

    None of this mess printed is actually proven!! Thanks to this article women will now take diet pills while pregnant, instead of making up studies with no proof, but only risks and may this and at risk if this, a risk doesn't mean it actually happen!!! Try to find ways to promote healthy diets for pregnancy instead of articles that just suggest and use the words at risk!!!!!

    April 16, 2014 at 12:43 | Report abuse | Reply
    • Ruby

      I agree with everything you have said. Diet pills were prescribed to pregnant women in the 1960s to control weight gain during pregnancy. After many babies were born disabled, doctors stopped prescribing them.

      April 16, 2014 at 12:56 | Report abuse |
  6. Ruby

    I was considered obese when I got pregnant with my child. I delivered a perfectly alive, healthy, happy, bright baby who is developing normally and thriving. He is also very smart. I have blood work done every 3 months and although I am not at a weight the doctor in this article would approve of, I have been given the okay by my internist and 3 obstetricians to get pregnant again. I always bring up the fact that I am not at my ideal weight and while they would like to see me lose 30 pounds before getting pregnant again, they tell me to go for it because my labwork indicates no health concerns.

    Normal weight women can have medical issues that will affect a pregnancy too. I really think the doctor in this article is just fat shaming women who want to get pregnant. The medical advice should be to keep on top of your health with regular blood tests and doctor visits. Just because you fit into the right BMI means nothing about the stare of your general health. Women with the right BMI can have high blood pressure and heart disease and are also at risk for delivering a stillborn. It's the chance you take with getting pregnant regardless of how much you weigh.

    April 16, 2014 at 12:49 | Report abuse | Reply
  7. Mike

    There is no such thing as an "unborn baby". It is a oxymoron.

    April 16, 2014 at 20:39 | Report abuse | Reply
  8. Johnna

    "We found weak, but statistically significant increases in risk even within what is considered the normal ranges of BMI," lead study author Dagfinn Aune said in an e-mail. "For example, the relative risk of stillbirth, perinatal and infant death increased by 20%, 11% and 10% already at a BMI of 25 compared with a BMI of 20, however, the really strong associations were observed among women who were either obese or severely obese who had up to two- to three-fold increases in the risk compared to lean women."

    So what is the actual beginning stillbirth percentage of those with a BMI of 20? Or better yet, what is total percentage of stillbirths, of all pregnancies, at each "class level"of obesity exists in the United States?

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