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Overweight or obese and pregnant


Postpartum (after delivery)


Thrombosis: Obese women are at a significantly higher risk of venous thromboembolism (VTE) and this risk is highest in the days after delivery. This is the case whether the delivery was vaginal or caesarean section. Venous thrombo-embolism (VTE) is a serious and potentially life threatening complication. In fact, in many western countries, it is the leading cause of maternal death.


Newborn morbidity: All the problems discussed above occurring in pregnancy and during deliver mean babies born to obese mothers are faced with a myriad of risks. These could result from fetal malformations, preterm delivery or a difficult and traumatic birth. The rate of admission to a special care baby unit for these babies is more than three times the average.


Stillbirth and neonatal death: Because of the higher rate of many pregnancy complications, the risk of stillbirth is significantly higher among obese women. The risk of unexplained stillbirth is also higher. Overall stillbirth is three times higher for obese women. The risk of death of the baby in the neonatal period (first month of life) is also increased by about the same degree.


Child’s long term health: A child born to an obese mother carries with him/her long term health consequences. Recent research findings show that maternal obesity during pregnancy increases the risk of asthma for the child. These children are also at a higher risk of coronary heart disease in their own adulthood. Their fate on this front is sealed in their mothers’ wombs many years in advance.



Cost


In the UK, women who embark upon a pregnancy whilst obese have, on average, a hospital stay six times longer than their normal-weight counterparts. The cost of the care they receive in pregnancy is also about five times higher. As health care is universal and free in the UK, the mother may not feel the impact of this directly.


In countries such as the United States where this is not the case, the personal financial implication could be enormous. This is particularly significant because obesity affects the poorer members of society a great deal more and these are the people who are likely to be uninsured. The cost of the birth alone in a low risk Birth Center in the United States is around $3000 to $4000. However, since obesity is regarded (correctly) as a high risk factor, Birth Centers will not accept an obese woman to have a baby there. The birth in hospital costs twice as much (if it is normal). That cost spirals dramatically when it is complicated or a cesarean section is required.



Last update: September 17, 2012





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