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Chapter 6 - Obesity in Pregnancy

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Gabrielle Cassir ,
Amira El-Messidi  and
Cynthia Maxwell
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 31-year-old nulligravida with a body mass index (BMI) of 42 kg/m2 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling. Prior to the consultation, you highlight to your obstetric trainee that motivational interviewing with nonstigmatizing terminology avoids negative influences on mood and self-esteem, promoting patient uptake of weight management strategies and a healthy lifestyle.

Keywords

ObesityPreconception counselingPhysical examinationMaternal investigationsFertilityObstructive sleep apneaAdverse perinatal outcomesCongenital anomalies, risk reductionPregnancy post bariatric surgeryPrenatal careObstetric deliveryStillbirth, causationHormonal contraception post gastric bypassPostpartum care
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 67 - 82
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

(a)American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins – Obstetrics. Obesity in pregnancy: ACOG Practice Bulletin, No. 230. Obstet Gynecol. 2021;137(6):e128–e144.Google Scholar
ACOG Practice Bulletin no. 105: Bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–1413.CrossRefGoogle Scholar
Benhalima, K, Minschart, C, Ceulemans, D, et al. Screening and management of gestational diabetes mellitus after bariatric surgery. Nutrients. 2018;10(10):1479.CrossRefGoogle ScholarPubMed
Ciangura, C, Coupaye, M, Deruelle, P, et al. Clinical practice guidelines for childbearing female candidates for bariatric surgery, pregnancy, and post-partum management after bariatric surgery. Obes Surg. 2019;29(11):3722–3734. [Correction in Obes Surg. 2020 Sep;30(9):3650–3651]CrossRefGoogle ScholarPubMed
(a)Denison, FC, Aedla, NR, Keag, O, et al. Care of women with obesity in pregnancy. Green-Top Guideline No. 72. BJOG 2018.CrossRefGoogle Scholar
Royal College of Obstetricians and Gynaecologists. The role of bariatric surgery in improving reproductive health. Scientific Impact Paper No. 17. October 2015.Google Scholar
D’Souza, R, Horyn, I, Pavalagantharajah, S, et al. Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol MFM. 2019;1(4):100041.CrossRefGoogle ScholarPubMed
(a)Maxwell, C, Gaudet, L, Cassir, G, et al. Guideline No. 391 – Pregnancy and maternal obesity part 1: pre-conception and prenatal care. J Obstet Gynaecol Can. 2019;41(11):1623–1640.Google Scholar
Maxwell, C, Gaudet, L, Cassir, G, et al. Guideline No. 392 – Pregnancy and maternal obesity part 2: team planning for delivery and postpartum care. J Obstet Gynaecol Can. 2019;41(11):1660–1675. [Correction in J Obstet Gynaecol Can. 2020 Mar;42(3):385]CrossRefGoogle ScholarPubMed
McAuliffe, FM, Killeen, SL, Jacob, CM, et al. Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non-Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline. Int J Gynaecol Obstet. 2020;151(Suppl 1):16–36.Google Scholar
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Management of obesity in pregnancy. C-Obs 49, March 2017.Google Scholar
Simon, A, Pratt, M, Hutton, B, et al. Guidelines for the management of pregnant women with obesity: a systematic review. Obes Rev. 2020;21(3):e12972.CrossRefGoogle ScholarPubMed
Vitner, D, Harris, K, Maxwell, C, et al. Obesity in pregnancy: a comparison of four national guidelines. J Matern Fetal Neonatal Med. 2019;32(15):2580–2590.Google Scholar

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