A new study by the University of Pittsburgh Schools of the Health Sciences found obese women are more likely to give birth to stillborn babies than normal-sized women. This is due to several, possibly preventable, medical complications, including maternal hypertension and placental diseases. The study was published online and will appear in the October issue of the American Journal of Clinical Nutrition.
“We’ve known for some time that obese women are more likely to have stillbirths, but this is one of the first and most comprehensive efforts to figure out why,” noted lead author Lisa Bodnar, Ph.D., M.P.H., R.D., associate professor in Pitt Public Health’s Department of Epidemiology. “Our hope is that this work can be used to better counsel women on the importance of a healthy pre-pregnancy weight and monitor them for complications during pregnancy that may threaten the survival of their fetuses.”
“This study also could be used to guide prevention efforts at a societal level,” she said. “If we can reduce pre-pregnancy obesity by even a small amount, through environmental or policy changes, we could significantly reduce the burden of stillbirth.”
Every year 3.2 million stillbirths occur around the world. In terms of high-income countries, the U.S. has one of the highest stillbirth rates. Obesity is believed to be the main cause of stillbirths in the U.S. and other high-income countries as opposed to other factors such as age and smoking.
Dr. Bodnar and colleagues studied records from 658 stillbirths occurring between 2003 and 2010 at Magee-Womens Hospital of UPMC. The hospital boasts one of the largest labor and delivery units in the U.S. The rate of stillbirths per 1,000 births was 7.7 for “lean” women, and 17.3 for women classified as “severely obese.”
Maternal hypertension, placental diseases, fetal abnormalities, and umbilical cord abnormalities are more common in obese women.
“Obstetricians should monitor obese patients for these complications and quickly treat conditions like hypertension if they arise in order to reduce risk of stillbirth,” said senior author Hyagriv N. Simhan, M.D., professor and chief of the division of maternal-fetal medicine and medical director of obstetrical services at Magee. “However, we’d like to see these women before they even become pregnant. When a doctor has an obese patient who is considering pregnancy, she should be referred to a maternal-fetal medicine specialist who can counsel her on the benefits of losing weight before pregnancy, as well as safe approaches to weight loss.”
This study emphasizes what many already know: a healthy weight is imperative to a healthy pregnancy!