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SPECIFICS OF PREGNANCY AND CHILDBIRTH IN OVERWEIGHT WOMEN
Kambarova Mushtariybonu Shukhratjon kizi
1st year master's student of the Department of Obstetrics and Gynecology in Family Medicine,
Tashkent Medical Academy
Abstract:
Overweight and obesity are increasingly prevalent among women of reproductive age
and represent significant clinical challenges during pregnancy and childbirth. Excess maternal
weight is associated with numerous complications, including gestational diabetes mellitus,
hypertensive disorders, labor dystocia, cesarean section, macrosomia, and neonatal morbidity.
This article explores the physiological, obstetric, and perinatal implications of maternal
overweight, the underlying pathophysiological mechanisms, and current best practices in
antenatal management, intrapartum care, and postpartum follow-up. By addressing these issues
holistically, clinicians can better individualize care, mitigate risks, and support healthy maternal
and neonatal outcomes.
Kеywоrds:
maternal obesity, pregnancy complications, gestational diabetes, cesarean delivery,
perinatal risks, antenatal care, labor management.
INTRОDUСTIОN
Maternal overweight and obesity have become major public health concerns worldwide, with
rates rising steadily due to sedentary lifestyles, poor nutrition, and socioeconomic factors.
Defined as a div mass index (BMI) of 25.0–29.9 kg/m² for overweight and ≥30.0 kg/m² for
obesity, excess weight before or during pregnancy is a well-documented risk factor for adverse
maternal and neonatal outcomes. For obstetric care providers, managing the pregnancy and
delivery of overweight women requires a proactive, multidisciplinary approach grounded in early
identification, risk stratification, and targeted intervention.
Unlike in normal-weight pregnancies, overweight women often experience altered physiology,
reduced placental efficiency, increased inflammatory markers, and insulin resistance, all of
which contribute to a heightened risk profile. Understanding the specificities of pregnancy and
childbirth in this population is essential to optimizing care plans and preventing complications.
MАTЕRIАLS АND MЕTHОDS
In overweight women, baseline metabolic and cardiovascular alterations become further
exaggerated during pregnancy. Increased adipose tissue contributes to systemic inflammation,
hormonal imbalance, and insulin resistance. This pathophysiological environment predisposes
these women to gestational diabetes mellitus (GDM), preeclampsia, and thrombophilic states [1].
Furthermore, excess fat accumulation in the abdomen and pelvic area complicates uterine
contractility, cervical effacement, and fetal descent during labor. Higher leptin levels may
interfere with myometrial sensitivity to oxytocin, leading to prolonged or dysfunctional labor.
Additionally, obese women often have altered respiratory mechanics and cardiac output, which
complicates anesthetic management and increases the risk of maternal hypoxia during delivery.
RЕSULTS АND DISСUSSIОN
Effective management begins in early pregnancy or ideally preconception. Overweight women
should receive counseling on nutritional optimization, physical activity, and weight gain targets
according to Institute of Medicine (IOM) guidelines. For example, the recommended gestational
weight gain for overweight women is 15–25 pounds (7–11.5 kg), and for obese women, 11–20
pounds (5–9 kg).
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Beyond the well-documented metabolic and mechanical complications, the clinical management
of overweight and obese pregnant women must also consider less frequently addressed yet
equally important domains: pharmacokinetics, mental health implications, surgical planning
logistics, and postpartum recovery patterns [2].
Obesity significantly alters the absorption, distribution, metabolism, and excretion of many drugs
commonly used during pregnancy and childbirth. For instance, lipophilic medications such as
anesthetics, antihypertensives, and insulin analogs may demonstrate prolonged half-lives or
reduced efficacy due to sequestration in adipose tissue or altered plasma protein binding.
Overweight women are disproportionately affected by antenatal and postpartum depression,
div image distress, and stigmatization in healthcare settings. These psychosocial stressors can
negatively influence prenatal care attendance, labor experiences, and maternal-infant bonding.
Psychological evaluations and support should be integrated into routine prenatal care for
overweight women. Screening tools such as the Edinburgh Postnatal Depression Scale (EPDS)
should be employed more proactively, and referrals to perinatal mental health specialists must be
normalized and destigmatized [3].
Group-based antenatal care models, such as CenteringPregnancy, which promote peer support
and education, have shown promise in improving maternal self-efficacy and satisfaction among
high-BMI populations.
Wound closure techniques, such as subcutaneous drain placement or negative-pressure wound
therapy, may be considered to reduce surgical site infection rates. The importance of
preoperative weight documentation, early mobilization, and DVT prophylaxis must be
emphasized across the care continuum.
The postpartum period presents a critical opportunity for metabolic resetting and risk
modification. Overweight women who experienced gestational diabetes or preeclampsia are at
significantly increased risk for type 2 diabetes mellitus, hypertension, and cardiovascular disease
later in life.
Breastfeeding, which has demonstrated protective effects against future metabolic disease in both
mother and infant, should be actively supported through lactation consultants, as initiation and
duration rates are often lower in this group.
Ultimately, transitioning from high-risk pregnancy to chronic disease prevention requires a
longitudinal model of care, ideally involving family medicine or internal medicine specialists in
collaboration with obstetricians [4].
СОNСLUSIОN
The management of pregnancy and childbirth in overweight women requires tailored strategies
that address the increased physiological and obstetric risks associated with excess maternal
weight. From preconception counseling to postpartum surveillance, every stage of care demands
a multidisciplinary, evidence-based approach. With the global rise in obesity, optimizing
outcomes in this high-risk population is an urgent priority in modern obstetrics. Clinicians must
not only mitigate risks but also empower women through education, support, and respectful care
that avoids stigma and promotes long-term maternal and neonatal health.
RЕFЕRЕNСЕS:
1.
Catalano, P. M., & Shankar, K. (2017). Obesity and pregnancy: Mechanisms of short
term and long term adverse consequences for mother and child. BMJ, 356, j1.
https://doi.org/10.1136/bmj.j1
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2.
Kominiarek, M. A., & Peaceman, A. M. (2017). Gestational weight gain. American
Journal
of
Obstetrics
and
Gynecology,
217(6),
642–651.
https://doi.org/10.1016/j.ajog.2017.05.040
3.
Mottola, M. F., & Artal, R. (2016). Role of exercise in reducing gestational diabetes
mellitus.
Clinical
Obstetrics
and
Gynecology,
59(3),
620–628.
https://doi.org/10.1097/GRF.0000000000000219
4.
Rasmussen, K. M., & Yaktine, A. L. (Eds.). (2009). Weight Gain During Pregnancy:
Reexamining the Guidelines. Institute of Medicine and National Research Council. Washington,
DC: The National Academies Press.
