14 Jun Early Pregnancy Obesity Linked to Fetal and Infant Death
In a 2005 Los Angeles study, researchers found that one out of five adults is obese. Currently, the Centers for Disease Control and Prevention (CDC) reports that 70% (two-thirds) of Americans are overweight and 37% (roughly one-third) are considered obese. What’s more shocking is that 6% have extreme obesity.
With early pregnancy obesity, the woman is at risk for fetal and infant death and maternal pregestational diabetes. This 2011 study was the first to examine the continuous relationship between body mass index (BMI) and fetal/infant deaths. The investigators have linked data on single birth pregnancies from 3 regional registers in the United States.
Miscarriage or spontaneous fetal death is any loss of pregnancy at 20 weeks gestation or more. Infant death is any loss of a child from birth up to one year. Underweight is considered a BMI of 25 to 29.9 kg/m2, obese as a BMI of 30 kg/m2 or more, and recommended BMI as 18.5 to 24.9 kg/m2. The crude and adjusted odds ratios of spontaneous fetal death and infant death among obese, overweight, and underweight women were determined using the logistic regression model. The study found that risks for fetal and infant death were greatly increased for obese women.
In reference to the categories, no significant excess risks were seen for those underweight or overweight. For the obese women, no specific cause of death was found to explain the increased odds of fetal or infant death, except for slight higher rates for preeclampsia among stillbirths. Experts are unsure why obesity is associated with fetal and infant death, but not exactly sure why. It is noted that there is a risk for increased blood pressure and diabetes during pregnancy, but how obesity is related to miscarriage is not yet known.
Most women will deliver a healthy baby, regardless of weight. However, women who are struggling with fertility should consider weight loss before conception. Current research shows that this gives the baby the best possible start in life. Women should attempt to lose weight during the pregnancy, but should also ensure that they eat a balanced, healthy diet and avoid excess high-fat, high-calorie foods.
A team of researchers based in the US and Sweden decided to test the theory that maternal weight was related to infant mortality. They analyzed over 1.8 million birth records from 1992 to 2010. The causes of death among these infants included birth asphyxia, congenital anomalies, infections, and sudden infant death syndrome (SIDS). The results were adjusted for maternal height, age, smoking, country of birth, education, and year of delivery.
A total of 5,428 infant deaths were noted during the study, which was 2.9 per 1,000 infants born. Of these deaths, two-thirds occurred during the neonatal period (first 28 days of life). As noted in the study, the infant mortality rates went up with increasing maternal BMI in early pregnancy, with 6 deaths per 1,000 women with obesity. When compared to infants of normal weight mothers and those only mildly obese, whereas mothers with obesity grade 2 or 3 had more than doubled risks of infant mortality.
In the study, the association between infant mortality and maternal weight was confined to the first 37 weeks gestation in the neonatal period (within 28 days of birth). Infant mortality is associated with obesity grade 2-3 in preterm births. Also, 81% of infant deaths in term infants were due to birth asphyxia, congenital anomalies, SIDS, infections, and other neonatal morbidities.