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Study shows health risks of obesity during pregnancy

Jesse Mellott | Fulcrum Staff

A recent study by Dr. Darine El-Chaar and University of Ottawa professor Dr. Mark Walker explores the correlation between obesity and pregnancy and the health problems that can occur when an expectant mother is overweight.

The study, entitled “The Impact of Increasing Obesity Class on Obstetrical Outcomes,” came to be as a result of the Ottawa Civic Hospital having a referral centre for overweight pregnant women, said El-Chaar, who was the study’s main author.

“The paper discusses what underlying health problems they already have—basically what obesity contributes to the pregnancy,” she said. “Then how obesity affects how they deliver—that they had a higher rate of caesarean sections, and they were more likely to be induced, meaning that the physician would have them deliver earlier because they were concerned about the pregnancy.”

According to Statistics Canada, 23 per cent of women of child-bearing age in Canada are obese, and obstetricians say it’s not uncommon in today’s society to see expectant mothers with a body mass index (BMI) of 50 (obesity is defined as a BMI of 30 or more).

Walker, a high-risk obstetrician at the Ottawa Hospital and obstetrics and gynaecology professor at the U of O, says this is a new phenomenon.

“This wasn’t an issue five years ago,” said Walker, who also noted that a lot of the expectant mothers he’s seen in his work aren’t just a little overweight but are morbidly obese, with a BMI over 40.

The study, which was El-Chaar’s residency project, was made possible because of a clinic created by two of her colleagues, Dr. Jacques Sylvain and Dr. George Tawagi. The clinic made special equipment available and allowed for extra testing and follow-ups with obese expectant mothers.

“We realized that we couldn’t take care of them as [we would] other pregnant women,” said El-Chaar. “They needed different resources, they needed different equipment, and they needed different access. That was an issue if you’re on call and you want to transfer a patient and you couldn’t in a normal wheelchair and … they didn’t fit,” said El-Chaar.

Sylvain, who was also El-Chaar’s residency advisor, agrees with El-Chaar’s observations.

“They are prone to have a lot of complications,” said Sylvain. “They have difficulty getting pregnant; second, when they are pregnant, it is difficult to assess them; and during the pregnancy, they have babies that are quite large and … higher incidences of pregnancy complications.”

The complications encountered by obese expectant mothers do not affect them alone, El-Chaar explained.

“Women who are obese were less likely to breastfeed; those were the main outcomes,” said El-Chaar. “Other studies have identified that these babies tend to have what we call a longer outcome—they might be more at risk for cardiovascular [problems], heart disease, [and] diabetes.”

El-Chaar hopes that the study will inspire awareness and prompt change.

“I think at this point it is important to recognize that it is a major health problem, and we do need to start looking at addressing how we can incorporate change, [and] start to be proactive about our health system.”