Losing weight may be the new key to having a healthy baby
Overweight women wanting to get pregnant are being recruited for an Australian-first study, with researchers hoping to prove why losing weight before conception is just as important to the baby — as it is to the mother. HOW YOU CAN TAKE PART.
LOSING weight before getting pregnant may be as important for your baby’s health as stopping smoking and taking folate.
An Australian-first study is hoping to show this simple change could massively reduce the rates of stillbirth, hypertension, diabetes, miscarriage, preterm birth and caesarean delivery.
These are medical complications that not only harm mothers but can even kill their unborn children.
Currently one in two pregnant women is classed as overweight, which has led to issues such as the rate of gestational diabetes almost doubling since 2013, going from 7 per cent to 13 per cent and affecting 12,375 women.
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Sydney University researchers are recruiting overweight women with a body mass index over 25 to participate in a trial that will test two weight loss programs before conception.
If this pilot study is a success, a much wider study will take place.
Royal Prince Alfred Neonatologist Dr Adrienne Gordon said losing weight before getting pregnant can boost fertility, increasing a woman’s ability to fall pregnant naturally.
Compared with women with a healthy BMI, overweight women have more fertility problems. A study in fertility conducted by Royal Prince Alfred Hospital found weight loss was associated with a three-fold increase in live births.
Conversely, being overweight during pregnancy can have a major impact on both the mother and child.
“One in two pregnant women are overweight, that is the new normal,” Dr Gordon said.
“The downstream effects include a higher rate of miscarriage, stillbirth, preterm birth, gestational diabetes, high blood pressure and a higher rate of caesarean sections.
“Babies born to overweight mothers are generally larger and a larger birth weight is a risk factor for childhood obesity.
“It is a safer and more beneficial time to start losing weight before pregnancy.
“Losing weight could be like normal preparation for pregnancy — like taking folate and stopping smoking,” Dr Gordon said.
“The big picture in the short term is to improve outcomes for both mother and baby, reduce pre-term birth, stillbirth and the like.
“In the long term, it is to reduce metabolic disease in the next generation.
“If you have gestational diabetes, you are five to seven times more likely to develop type two diabetes. So we want reduce mothers’ risk of these things in pregnancy because it reduces the risk of developing these things later in life.
“If we can get an optimal weight before pregnancy we can improve the outcomes for both mother and child and also improve the risk of the next generation, of the children developing obesity and then metabolic disease like diabetes and hypertension.”
Maternal obesity is now considered one of the most commonly occurring risk factors seen in obstetrics and the associated statistics are stark.
An Australian study of 14,230 pregnancies found the odds of developing gestational diabetes if overweight was almost triple that of normal weight mothers.
“Women who have had gestational diabetes also have a higher risk of developing diabetes in the future, as do their children,” Dr Gordon said.
According to the Australian Institute of Health and Welfare report into maternal deaths, “heart disease and blood clots in lungs are the common causes of maternal deaths” and both are associated with obesity.
A meta-analysis of nine studies found a doubling in the risk of stillbirth among obese women. Women BMI over 30 had a stillbirth rate of 6.9 per 1000 births compared with 4 per 1000 total births in women with a healthy BMI.
There were 591 stillbirths and almost 1200 babies born under 1.5kg last year according to the 2018 NSW Mothers and Babies report and obesity has played a role.
While children of obese mothers are at double the risk of developing obesity and metabolic syndrome.
“Under and over-nutrition affects metabolically how babies will respond in life,” Dr Gordon said.
And, while weight loss studies have been conducted in women with fertility problems, this pilot study is the first of its kind to target the general population of women before conception.
The trial will randomly place 60 women on one of two weight loss programs over 10 weeks. One will be an online supported weight loss program called Flexi. The diet consists of two meal replacement shakes with a high protein dinner for six days and one day of eating normally.
The control group will be on the Get Healthy NSW program, which provides online resources, coaching and a healthy eating plan.
“We want to look at which one will work well in the pilot before we conduct a larger study,” Dr Gordon said.
Aedin Treloar, 39, signed up for the trial two weeks ago. She has been on the Flexi diet and has already lost four kilograms.
“I just felt like I needed to be in the best health I could before I got pregnant and I thought well, this will help me lose the baby weight,” she said.
She was always in good shape and even went to boot camp during her first pregnancy but after her first child 19 months ago, bad eating habits led to weight gain.
At 87 kilos, her BMI is around 31.
“I gained nine kilograms after I had my baby when I was breastfeeding because you’re tired and you make bad choices, I just overate,” she said.
The Earlwood midwife has seen the downside of carrying too much weight during pregnancy among her patients.
“Absolutely, you see people eating for two and it’s not a good place to be, you need to be as fit as you can be,” she said.
Women with a BMI above or equal to 25 and planning a pregnancy in the next 6 to 12 months can contact cpc.baby1000@sydney.edu.au
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