How does being overweight affect pregnancy?

According to statistics, women who are overweight are more likely to face the problem of infertility than those with normal body mass index values. It's all about the hormonal activity of adipose tissue. It produces many hormone-like substances that act at the systemic level and affect the reproductive system. And as a result - hormonal imbalance and problems with ovulation.

If pregnancy occurs, being overweight significantly increases the risk of miscarriage.

To eliminate these problems with conception and pregnancy, a woman needs to normalize her body weight as much as possible already at the stage of pregnancy planning.

How to determine if a woman is overweight

The most objective indicator for calculating body mass index (BMI) is bioimpedance measurement or body composition analysis. With the help of such a quick and safe diagnosis, you can find out the level of metabolism, the amount of adipose tissue and its distribution in the body, calculate physical activity and, together with your doctor, draw up an effective plan for normalizing parameters.

You can calculate your body mass index yourself. It is determined by the formula: mass in kilograms divided by the square of height in meters. A BMI of 18 to 25 is normal, a BMI of 25 to 29 is overweight, and a BMI of 30 or higher indicates obesity.

Reproductive dysfunction begins already with a BMI of 25-26, and as the numbers increase, the risk of developing infertility also increases. At the same time, excess weight is an obstacle not only to natural conception, but also to successful IVF and to further pregnancy.

There are also a number of cases when women who do not appear to be overweight actually have a metabolic disorder; correction of this disorder must also be carried out before planning a pregnancy.

Delivery of an overweight pregnant woman

The process of childbirth for a woman can become very long and difficult, especially if the index exceeds 40. The most common complications in this situation are:

• premature onset of labor before 37 weeks;
• child's shoulders getting stuck;
• difficulty in performing a caesarean section;
• increased risk of postoperative complications during cesarean section;
• complication when choosing an anesthesia regimen;
• postpartum bleeding in severe form, especially if excess weight is associated with pathologies such as diabetes, etc.

The effect of excess weight on reproductive function

Excess weight provokes hormonal imbalance.

In the adipose tissue of the female body, male hormones androgens are converted into female hormones - estrogens. When it is in excess, the amount of estrogen exceeds the norm. As a result, an imbalance is formed, which manifests itself in the form of various problems, one of them is related to childbirth and problems at the conception stage. The more excess weight you have, the higher the risk of difficulty conceiving.

Excess weight, especially excess abdominal fat, is associated with insulin resistance (when the body has to produce more insulin to keep blood sugar at normal levels) and decreased levels of sex hormone binding globulin, a protein that is involved in regulating the sex hormones androgens and estrogens. This increases the risk of irregular menstrual cycles, which in turn reduces fertility.

Changes in hormonal balance due to obesity also increase the risk of anovulation. This menstrual cycle disorder is characterized by the absence of ovulation. Many overweight women still ovulate, but the egg quality is significantly lower than in women of normal weight.

With IVF, the likelihood of a normal course and completion of pregnancy in women with overweight or obesity is lower than in women with a normal BMI. On average, the likelihood of having a healthy baby with IVF is reduced by 9% in overweight women and by 20% in obese women.

What are the dangers of excessive weight gain during pregnancy and how to eat properly?

07/09/2020 What are the dangers of excessive weight gain during pregnancy and how to eat properly? Doctors, observing the course of a woman’s pregnancy, carefully monitor weight gain. The expectant mother is warned that extra pounds are harmful not only to her health, but also to the development of the fetus. Excess weight gain can also cause complications during childbirth. There is an opinion among the population that a pregnant woman should eat “for two” and excessive weight gain is inevitable, but experts say that the expectant mother’s diet should be balanced, and there is absolutely no need for extra pounds during pregnancy. Excessive weight gain during pregnancy is quite common. It is important to understand the reasons that cause it and understand why pathology is dangerous during pregnancy. After all, what is at stake is not only and not so much the beauty of a woman, but her health, as well as the health of the unborn baby. Excessive increase in pregnancy weight can occur for various reasons. The main ones include: - Overeating. Many women, having learned about their situation, make the mistake and start eating for two. Doctors warn against this step. The health of mother and child will be preserved when a woman’s diet during the 9 months of bearing a baby is varied, healthy and balanced. In this case, “a lot” does not mean “useful.” — A sedentary lifestyle of the expectant mother, as a result of which the body cannot use up all the kilocalories received per day. The excess remains as fat. — Endocrine disorders. Existing chronic ailments, which a woman may not have known about before conception, can become aggravated and intensify during pregnancy. Optimal weight gain During pregnancy, a woman gains weight unevenly. In the first half, about 40% is gained, and in the second - 60% of the weight. Ideally, in 9 months the expectant mother will gain 9-15 kg. This weight gain allows a woman to maintain her health and figure and quickly get back into shape after childbirth. Of 15 kg, only a fifth is fat mass. The rest is distributed between the weight of the fetus, placenta, amniotic fluid of the enlarging uterus, mammary glands and additional blood volume. The rate of weight gain for each woman is individual. An increase of more than 1 kg per week or an unchanged number on the scale should alert a woman. This must be reported to your doctor. What are the dangers of excessive weight gain? Often a woman does not pay attention to how much weight she has gained, because she does not know about the consequences for the mother and the baby. Consequences for a woman Excess weight during pregnancy is dangerous for the expectant mother in the following ways: - the development of preeclampsia, diabetes mellitus in pregnant women, - excess weight can provoke both premature birth or miscarriage, and post-maturity; — the risk of emergency caesarean section increases, which is difficult to perform in case of obesity; - increases the likelihood of severe postpartum hemorrhage, difficulties in administering anesthesia and anesthesia during childbirth; — the likelihood of varicose veins, hemorrhoids, heart and vascular diseases, and nervous system increases many times over; - recovery after childbirth and return to prenatal form will be very difficult and lengthy: Consequences for the child The extra pounds gained by the mother are dangerous: - the appearance of a large child, which can complicate childbirth; — intrauterine fetal hypoxia; - increased risk of developing neurological problems in the baby, as well as heart disease; the child's predisposition to excess weight. Pregnancy with excessive weight gain requires close medical supervision. This is necessary in order to minimize the risk of developing diseases and complications during childbirth. Proper nutrition Pregnancy is perhaps the most favorable period to learn how to eat properly. The basis of the diet should be meat, fish, eggs, dairy products, fresh vegetables and fruits. It is necessary to eat as little fried, fatty, and sweet foods as possible. If the expectant mother is overweight, she should reduce the amount of calories consumed, but no more than 10%. Remember, fats are necessary for the developing fetus. Among the foods containing fats, pregnant women are recommended: cheeses, sour cream, whole milk, yogurt, nut butter, egg, avocado, light turkey meat or skinless chicken, salmon, tuna, vegetable and butter.. Eat often, but in small portions. You can drink a glass of water before each meal. You should know that spicy, salty dishes and broths stimulate the appetite, and confectionery, sweets, and sweet fruits are quickly absorbed and digested - try to limit their consumption, or better yet, eliminate them altogether. Remember, salt provokes fluid retention in the body, so it would be appropriate to limit its amount. Be careful with chocolate. In addition to extra calories, it saturates the body with caffeine, which complicates the absorption of iron, folic acid and calcium. There is no need to go to extremes at all - the main thing is to learn to control your weight. Under no circumstances should you go hungry. In addition to the threat of miscarriage, fasting is fraught with such undesirable consequences as the child’s low body weight (which threatens physical and psychological problems). Poor nutrition during pregnancy can damage the baby's brain and metabolism. If you suffer from toxicosis, you cannot refuse food. Eat something that doesn’t make you sick, often and in small portions so as not to provoke nausea again. Hunger will only increase the discomfort. Be sure to follow the rules of balanced nutrition during pregnancy - regardless of the extra pounds! Therapeutic gymnastics will only benefit you! In addition to burning extra calories, it will have a beneficial effect on your overall well-being and will perfectly prepare you for the upcoming birth, as well as facilitate postpartum rehabilitation. A set of exercises should be developed taking into account the duration of pregnancy and the degree of obesity. However, be careful. For various reasons, physical activity may be contraindicated - be sure to consult your doctor. In this case, long walks in the fresh air will be beneficial. And half an hour of daily walking (continuously, at a fairly fast pace) will only be useful! Control your weight! There are many different scales on the market that allow you to track all the necessary indicators. Weigh yourself daily in the morning immediately after going to bed. Don't forget that weight changes are also related to fetal growth. You can build a special graph of your baby's growth to make the process more clear. Head of antenatal clinic G.P. Polubotko

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Solving the problem of excess weight

As mentioned above, this problem must be solved at the pregnancy planning stage.

Losing weight increases your chances of getting pregnant - studies have shown that 80% of women who have lost at least 10% of weight have improved reproductive function without additional treatment. It also reduces the risk of complications during pregnancy and childbirth.

If your BMI is significantly higher than 25 and you are unable to get pregnant, it is better to contact a reproductive specialist in Krasnodar at the OXY-center, and also undergo additional diagnostics from an endocrinologist and nutritionist. Doctors will prescribe the necessary examination and, based on its results, draw up a treatment plan, give recommendations on lifestyle changes, nutrition, and adjust hormonal function with subsequent monitoring of ovulation.

Hormonal disharmony

A woman’s adipose tissue is hormonally active: the production of female sex hormones estrogen occurs here.

This means that the more fat, the higher the level of sex hormones. In this case, “a lot” does not mean “good”.

There is a wise ancient Chinese saying: “You can’t bite off more than you can chew.” Estrogens in our body must be balanced by progesterone, and it is produced in adipose tissue to a lesser extent - this causes hormonal imbalance. And this is a risk factor for infertility, as well as gynecological diseases, including very severe ones.

Pregnancy can also be seriously hampered by excess testosterone, a male hormone that is also produced in a certain amount in the female body. This hormone exists in two forms: in a “free” form and bound to protein, and only the free fraction of testosterone is biologically active. The process of its binding involves proteins (globulins) produced in the liver. Under the influence of excess weight, this organ begins to produce less proteins. As a result, the gonads and adrenal glands synthesize a normal amount of the hormone, but due to a lack of globulin, free testosterone turns out to be more than needed. Here we go again with hormonal imbalance and problems with conception.

By the way, the “culprit” of infertility can be extra pounds not only of the wife, but also of the husband. If overweight women have an excess of testosterone, then overweight men have a lack of it. It leads to disturbances in spermatogenesis with completely normal potency. Therefore, an overweight man is quite capable of being a husband, but becoming a father is much more difficult for him.

In a woman, hormonal imbalances can manifest themselves in the form of cycle disorders, or they can be invisible. Gynecologists conducted special examinations of obese women whose menstrual periods came on time, and found that their progesterone concentration was still much lower than that of women of normal weight.

When it is not possible to get pregnant naturally, many couples decide to undergo IVF - and in this case, excess weight is also a big hindrance. Attempts at such fertilization in curvy women end in success in a smaller percentage of cases (and this percentage is not very high anyway); they also require more serious hormonal preparation.

Normalization of weight in pregnant women

Losing weight before or during pregnancy is a much deeper process than just “keeping your mouth shut.” There is no need to do this. We will talk about diets for pregnant women in a separate article, but for now we will give one, the most important advice - remove too fatty, sweet and spicy foods from your diet, focus on natural products - vegetables growing in the ground and fruits growing on trees. Nature has endowed them with everything that expectant mothers need both for saturation and for the normalization of all vital processes.

Infertility in obese women

Both with primary and secondary obesity in women, there is a dysfunction of the hypothalamus and, as a consequence, disruptions in the activity of the hypothalamic-pituitary-ovarian system. The only difference is that they can either be the cause of this condition, or arise against its background.

Violation of the secretion of sex hormones, thus, according to the feedback principle, can cause disturbances in the regulation of the menstrual cycle on the part of the hypothalamus and pituitary gland.

Obese women often exhibit anovulatory cycles and luteal phase defects. Also, if you are overweight, there is a possibility that the patient will develop polycystic ovary syndrome with subsequent signs of androgenization. Why is this possible? The fact is that the male hormone androstenedinione, produced by the ovaries, is also converted into the female steroid hormone estrone, which in turn causes an increase in the sensitivity of the pituitary gland to the effects of gonadotropin-releasing hormone. In this regard, luteinizing hormone (LH) begins to be produced in the same excess quantities, without the peak release that normally initiates ovulation.