The prevalence of obesity worldwide has increased in the last decade. This is due to lifestyle changes, technological advancements, decreased physical activity, and consumption of cheap and high-calorie foods. In short, we are eating more and moving less in recent years. Obesity is a significant public health concern, and this issue is likely to continue in the near future. Maternal obesity increases the risk of unwanted conditions during pregnancy, including preeclampsia, gestational diabetes, and cesarean section. Weight gain during pregnancy and the inability to lose weight after childbirth predispose a woman to obesity later in life. The mother’s health has significant effects on the baby’s development in the womb and postnatal life.

The most commonly used measurement to define obesity is the division of body weight in kilograms by the square of height in meters. This is called the body mass index (BMI). If the body mass index is between 25-30 kg/m2, it is categorized as overweight; if it is above 30 kg/m2, it is categorized as obese, and if it is above 40 kg/m2, it is categorized as severely obese. However, this criterion can be misleading. For example, athletes may have a high body mass index due to excessive muscle mass. The risk for obesity is having a high percentage of body fat despite this limitation. Despite this limitation, the easiest way to express it is still the body mass index.

According to the utero-fetal programming hypothesis, the baby’s weight at birth is closely related to the development of diseases later in life. Scientific studies have shown a link between maternal obesity in the first three months of pregnancy and childhood obesity. The baby is constantly exposed to nutritional stimuli while in the mother’s womb. It regulates and is programmed based on the type of nutrients passing through the placenta, without checking for any deficiency or excess in the baby’s diet. This programming determines the baby’s future life. Poorly nourished mothers increase the risk of their babies developing heart disease, hypertension, and non-insulin-dependent diabetes in the future. Moreover, due to the programming of the baby in the mother’s womb, obesity can become permanent. When looking at the daughters of obese women, obesity is observed in the majority.

Fat tissue plays a significant role in the development of problems related to obesity. Fat tissue is an important type of tissue in the body. It plays a significant role in providing nutrition, hormonal support, and even structural support in the body. It stores fats to provide energy when needed. Fat tissue contains many immune cells and important cells. These cells and fat cells produce and secrete substances called cytokines and chemokines that affect the body, in addition to hormones. For example, the main source of estrogen detected in the blood of menopausal women is fat tissue. The imbalance among these substances can lead to the development of some health problems in obesity.

Maternal obesity can lead to some undesirable outcomes during pregnancy. Therefore, close monitoring of these women during pregnancy is necessary. Maternal obesity is a risk factor for miscarriages and stillbirths. Scientific studies have shown that the risk of stillbirth is twice as high in obese pregnant women compared to normal-weight pregnant women. This risk is closely related to increased high blood pressure and gestational diabetes during pregnancy. In obese pregnant women, the risk of a condition called preeclampsia, characterized by high blood pressure and protein loss in the urine during pregnancy, is also increased. Preeclampsia during pregnancy is a serious unwanted condition that poses a risk to both the mother and the baby. The risk of increased blood pressure during pregnancy increases linearly with the increase in body mass index. For every 5-7 kg/m2 increase in body mass index, there is a corresponding two-fold increase in the risk of preeclampsia.

The risk of complications during childbirth and delivery increases in obese women. As the mother’s body mass index increases, the chances of a successful vaginal delivery decrease. The rate of cesarean section is 2-3 times higher in obese women compared to normal-weight women when compared. This increase is valid for both first pregnancies and women who have given birth before. The duration of labor is also prolonged in these women. The same situation is observed in women who have gained excessive weight during pregnancy. Again, the likelihood of having a vaginal birth after cesarean section is low in obese women. They are at risk due to complications during childbirth, such as infection and blood clot formation in the blood vessels.

When it comes to its effects on the baby, the most important concern is the baby being significantly large in the mother’s womb. The baby’s birth weight increases as the mother’s body mass index increases. In obese individuals, there is a decrease in folic acid due to inadequate absorption, increased metabolic demand of the mother, and an increase in estrogen and insulin levels in the mother’s circulation. For these reasons, it has been suggested that obesity in women may lead to a 7% increase in the birth defect affecting the brain and spinal cord, called neural tube defect.

Maternal obesity is closely related to increased gestational diabetes. Although the exact cause is not yet known, increased insulin resistance is held responsible. During a normal pregnancy, due to the increasing production of insulin counteracting hormones released from the placenta, there is increased insulin resistance. This increased insulin resistance enhances the amount of fat in the blood, allowing for the baby’s growth and development. However, insulin resistance is higher in obese women compared to normal-weight women. This leads to weight gain in the baby.

Maternal obesity and accompanying unwanted conditions negatively affect the health of both mothers and babies. It increases the risk of diabetes and obesity in childhood. Overweight and obese women contemplating pregnancy should seek expert advice on nutrition and weight. They should be evaluated with a complete examination and tests. Losing 5-7% of your pre-pregnancy weight reduces the risk of unwanted conditions during pregnancy significantly. Healthy eating, increased physical activity, and exercise help you have a healthy pregnancy. Don’t miss your regular check-ups.