Heavier Pregnant Women Tend to Deliver Prematurely

In large Swedish study, risk rose along with the mother's weight

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 11 (HealthDay News) -- Overweight or obese women who are pregnant are more likely to give birth prematurely, and the risk of preterm delivery increases with their amount of excess weight, according to a study of more than 1.5 million deliveries in Sweden.

Researchers speculate that the health problems associated with overweight and obesity -- high blood pressure, insulin resistance, high cholesterol, increased chance of infection -- have a direct impact on a woman's ability to carry their child to term, according to the study, which was published in the June 12 issue of the Journal of the American Medical Association.

Birth of an infant prior to 37 weeks of gestation is the leading cause of infant mortality, neonatal illness and long-term disability in children, said researchers led by Dr. Sven Cnattingius of the Karolinska Institute in Stockholm.

A U.S. expert not involved with the study said he wasn't surprised by the findings.

"This just reinforces the fact that the complications of obesity and additional weight gain are deleterious to both mother and fetus," said Dr. Raul Artal, a professor and chairman of the department of obstetrics, gynecology and women's health at the Saint Louis University School of Medicine.

Artal said this study, along with previous research, makes the case that overweight and obese women who are pregnant can protect the health of their unborn child by maintaining their current weight or even shedding some pounds.

"The concept that we propagated for years that pregnancy is not a good time for weight loss and physical activity is wrong," he said.

For the study, researchers analyzed the records of 1.59 million births between 1992 and 2010, reviewing the body-mass index (BMI) of the women at their first prenatal doctor's visit as well as information recorded following birth about health risks, maternal diseases and pregnancy complications.

BMI is a measure of body fat based on height and weight.

The statistics came from the Swedish Medical Birth Register, which maintains detailed data on all births in that nation and serves as a valuable resource for researchers, a U.S. expert said.

"There's a lot of good obstetric data that comes out of Sweden because of that register," said Dr. Russ Fothergill, vice chairman of the department of obstetrics and gynecology at Scott and White Healthcare in Temple, Texas.

The researchers found that the risk of extremely premature (22 to 27 weeks), very premature (28 to 31 weeks) and moderately premature (32 to 36 weeks) deliveries increased with a woman's BMI.

The authors said that even though the study is Swedish, the results can be generalized to other populations with similar or higher rates of maternal obesity or preterm delivery.

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Do You Want to Deliver Your Baby Early?

By Joanne Barker
WebMD Feature

It’s your last month of pregnancy. You may feel worn out and more than ready for your baby to come. But if you’re tempted to shave a couple of weeks off this time, think again. Cutting your pregnancy short by even one or two weeks is not good for your baby.  

“For years, we thought babies born at 37 or 38 weeks were fine,” says Scott Berns, MD, MPH, FAAP, deputy medical director of the March of Dimes. But over the last 10 years, experts have learned that’s not true. “Babies born even a couple of weeks early have a higher chance of medical problems,” Berns says.

As more women try to plan childbirth around work, busy schedules, or their doctor’s vacation, it’s becoming popular to schedule delivery rather than wait for labor to start on its own.

The number of babies delivered through early induced labor almost doubled between 1992 and 2004. And the number of babies born between 36 and 38 weeks is going up, while the number of babies delivered at 39 weeks is going down.

That’s a problem. Even if your baby feels huge in your belly, important organs may still need to grow before he’s ready to enter the world. “Their brains aren’t fully developed. Their lungs aren’t fully developed. They have a higher risk of infections, and even a higher risk of death,” Berns says.  

Why Early Delivery May be Dangerous

Babies born earlier than 39 weeks are more likely to have serious medical conditions that land them in the intensive care unit.

Breathing problems because the baby’s lungs are not fully developed  Feeding problems because the baby may have trouble sucking or swallowingA serious infection that could be life threatening

Plus, babies born even a week or two early are often thinner, so they have a harder time staying warm. They’re also more likely to have vision or hearing problems throughout life.

When Early Delivery Is Your Only Option

Sometimes going full term is just too risky, so your doctor may recommend early delivery. It may make sense if you have diabetes or preeclampsia, if your baby isn’t growing, or if your water breaks. You want to make the best decision for your baby’s health and for your health. 

Play It Safe for Your Baby

Berns doesn’t blame pregnant women for the increase in early deliveries. They don’t realize the risk. “Over 90% of women believe it’s safe to deliver before 39 weeks. That’s a huge number,” he says.

To help reverse the trend, the March of Dimes has launched a campaign, Healthy Babies Are Worth the Wait. When parents find out how much the last weeks count, he says, they almost always decide to wait and let nature take its full course.

After all, you’d rather get to know your new baby at home, not surrounded by machines in intensive care.  

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