Wednesday, June 30, 2010
Obesity is a problem at any age. Doctors say it can be especially dangerous during pregnancy. Excess weight raises the risk of premature birth, diabetes, and a host of other health problems for both mothers and their babies.
SAN DIEGO Obesity is a problem at any age. Doctors say it can be especially dangerous during pregnancy. Excess weight raises the risk of premature birth, diabetes, and a host of other health problems for both mothers and their babies.
Cecelia Fryckman is going through her first pregnancy. She talks about how things are going with Dr. Jessica Kingston, her OBGYN at UC San Diego.
"Now how are you doing with your activities and your exercise?" asks Dr. Kingston.
"Um, the fatigue has set back in. So I'm really tired. I'm feeling like I need naps everyday," Fryckman replies.
Fryckman goes on to say she hasn't been able to walk, or do any other exercise.
"But we were just talking about it on the way here," Fryckman continues, "that we should try swimming, and see if that helps."
"Yeah," says Kingston, "especially at this point in pregnancy, that's an activity that I recommend a lot.
Fryckman is 29 years old. She says she's had a tough time with her weight her entire life.
Right before she got pregnant, she buckled down and lost 30 pounds. But since then…
"It's been hard," Fryckman points out. "I think I've gained a lot of it back, and it's kind of been a struggle to try to maintain the weight, and healthy weight for the baby, and for myself, as well."
Nearly two out of three American women of childbearing age are either overweight or obese.
Dr. Yvette LaCoursiere practices with Dr. Kingston at UCSD. She says over the last 20 years, there's been a 40 percent increase in the number of women who begin their pregnancy overweight.
"Not only has the percentage of women increased over the last period of time," says Dr. LaCoursiere, "But also the size of the patient has increased as well, such that at UCSD, about 18 percent of our women show up to labor and delivery over 250 pounds, and one percent to two percent over 300 pounds at the time of delivery."
LaCoursiere says women who are too heavy during pregnancy are really playing with fire.
"Overweight and obese women are at increased risk for most of our obstetric complications, starting from the first trimester," she says. "They're at increased risk for cesarean delivery, gestational diabetes, hypertension, both before pregnancy and during pregnancy."
These women also have a greater likelihood of delivering a baby who has fetal problems.
At the infant special care center at UCSD Medical Center in Hillcrest, babies are hooked up to monitors and fed intravenously.
Dr. Frank Mannino directs the center. He says gestational diabetes poses a major risk to newborns. Mannino says these babies are more likely to be born premature, and suffer from breathing problems.
What's more, Mannino says obese mothers may be setting up their infants for lifelong weight problems and other health issues.
"We're concerned that's what's happening in utero, because of whatever the situation is with the mother, could affect the fetus for the entire life," Dr. Mannino says.
"We won’t know about this for another generation."
The Institute of Medicine has recently revised its guidelines for weight gain during pregnancy. The IOM recommends obese women gain no more than 20 pounds.
Dr. LaCoursiere tries not to browbeat her patients about their weight. She instead likes to focus on healthy lifestyles, and the need for proper nutrition.
"I think part of it is setting the expectation with the patient early that it's part of an important prenatal health care picture," LaCoursiere says, "That their weight is directly related to the health of their baby, and women are very responsive to taking care of the health of their babies."
Cecelia Fryckman says she's trying to do the right thing. Fryckman has even consulted with a nutritionist to get tips on healthy eating. She thinks it's making a difference.
"But again," Fryckman says, "It's frustrating because even though I'm like, I'm doing all that, I'm still gaining, which is normal for the pregnancy, but at the same time, you feel like, oh, it's tough."
LaCoursiere has recently published a study that reveals yet another risk for pregnant women who are obese. The study indicates these women have a higher likelihood of suffering from post-partum depression.