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Obesity In Pregnancy: Maternal And Fetal Risks

Obesity in Pregnancy Guideline

MAHEC FM-OB Regional Collaborative

Preconception

All women contemplating a future pregnancy should have height, weight and BMI calculated

as part of a comprehensive preconception counseling visit. Women should be encouraged to

attempt to achieve an ideal body weight prior to conception. They should be counseled

regarding diet, exercise and appropriate weight for height.

Conception

At the initial OB visit all women should have height, weight and BMI calculated. If the

initial BMI is >35 the following should occur:

(1) Write Obesity (BMI =__) in the OB chart

(2) Counsel patient on the ideal amount of weight gain this pregnancy (see table). Remind

that it may be ok to NOT gain weight during pregnancy. Exercise is good, start a walking

program if currently sedentary.

(3) Refer to a dietician/nutritionist

(4) Begin antenatal surveillance starting at 36 weeks (twice weekly NSTs)

a. Explain the increased maternal and neonatal risks

(5) Induction planned in the 40

week of gestation

a. Accurate dating is important

b. Try to induce by 40w0d but do not let go to 41w0d

(6) Encourage breast feeding for all of its positive benefits including assistance in weight

loss

Women with BMIs ≥25 and ≤34.9 should be counseled on diet, exercise, and ideal weight

gain for this pregnancy (see table)

Postconception

(1) All women should be offered and engage in active family planning

(2) Encourage breast feeding

(3) Encourage diet, exercise and weight loss to achieve ideal body weight

(4) Refer to a dietician or nutrition

E. Blake Fagan, MD

Updated Nov 2011

Obesity In Pregnancy: Maternal And Fetal Risks