The prevalence of overweight and obesity is increasing worldwide, and women are at higher risk compared with men. Findings from the Global Nutrition Report 2017 have shown that 54% of overweight/obese women are of childbearing age. Maternal obesity can lead to adverse maternal and fetal complications before, during and after pregnancy. Before pregnancy, obesity can reduce fertility and increase the time it takes to conceive. During pregnancy, women who are obese face greater risk of experiencing complications such as gestational diabetes, pre-eclampsia, early pregnancy loss, congenital fetal malformations and large for gestational age infants. After pregnancy, obese women are more likely to experience weight retention and a delay or failure to lactate. Researchers suggest that there are two main factors that may lead to overweight or obesity during childbearing age. The first is due to excessive gestational weight gain and postpartum weight retention, and the second is related to subtle changes in behavior or lifestyle—such as increased caloric intake, a less healthy diet and reduced physical activity—in the postpartum period.
Developing effective strategies to prevent excessive weight gain in women of childbearing age before, during and after pregnancy is critical to avoiding obesity-related maternal and newborn health issues. Before pregnancy, efforts should focus on weight management in adolescents and young women in general in the event that they become pregnant. During pregnancy, health care providers should offer recommendations and support for women to facilitate adequate gestational weight gain based on pre-pregnancy body mass index (BMI). A recent study from the United States found that less than 30% of women reported receiving weight gain recommendations during pregnancy, which is critical given other data reporting that nearly half of women in the country gain excessive weight during pregnancy.
After pregnancy, health care providers should give nutritional and physical activity advice, including breastfeeding support to improve the health of the newly delivered women. During the postpartum period and time between pregnancies, efforts are needed to measure weight and height not only in babies but also in mothers. It is vital to monitor postpartum women’s BMI and support them in maintaining a healthy weight. This will help ensure that women enter any subsequent pregnancies with an optimal weight and keep or adopt healthy behaviors for the long-term (i.e., following a healthy diet, getting regular physical activity and breastfeeding).
Furthermore, it is important to consider weight change through childbearing years and examine weight beyond pregnancy when studying women’s risk factors for chronic diseases such as type 2 diabetes, hypertension and cancer because weight history may provide information beyond current weight. Established between 2006-2008, the Mexican Teachers’ Cohort (MTC) studies risk factors for chronic diseases—such as weight history, reproductive and lifestyle factors—to generate evidence for improving women’s health. The research team of the MTC is prospectively assessing the association between parity and lactation with long-term weight change to ascertain how these maternal factors alter women’s weight trajectories and to identify strategies for preventing excessive weight gain in women of childbearing age.
In the context of the global increase in obesity and other obesity-related diseases in women of childbearing age, there is an urgent call to health providers to spend more time assessing BMI, providing advice on optimal gestational weight gain, counselling on adequate interpregnancy intervals, supporting women who choose to breastfeed and to help them adopt healthy lifestyles during antenatal and postnatal care. Training providers in nutrition and weight-related counseling can have lasting improvements on both maternal and child health outcomes.
Learn more about maternal health and nutrition.
Watch experts discuss how pregnancy is a window of opportunity for improving health behaviors.
Browse other posts in the MHTF’s “Noncommunicable Diseases and Maternal Health” blog series.