Obesity in pregnancy

In recent years, the prevalence of obesity among UK women has increased substantially with 40% being overweight and 25% obese in 2010. In women of childbearing age, the excess body weight is of particular concern with obese parturients experiencing an increased incidence of complications compared with normal weight mothers. In addition to the maternal risks associated with excess body weight, fetal morbidity and mortality is also increased compared with pregnancies of normal weight mothers. Table 1 summarizes the maternal and fetal complications associated with excess maternal body weight. In addition to the consequences originating from perinatal morbidity, the longer-term complications of obesity include further maternal weight gain and an increased risk of development of obesity in the offspring. Furthermore, the increased use of maternity services associated with obesity in pregnancy adds significantly to health-care costs compared with normal weight mothers. Although much work has been put into recommendations on medical care for obese women planning pregnancy, including prenatal weight management and dietary advice, nearly one quarter of UK pregnant women are now obese. Data on the prevalence of maternal obesity from a large UK maternity hospital are presented in Figure 1. With an ever-increasing number of obese parturients, the maternity ward anaesthetist will be required to professionally anticipate and safely assist in the prevention of peripartum complications associated with excess body weight.