La grossesse chez la femme obèse : des conséquences sous-estimées ?

Abstract

As the prevalence of obesity grows in western countries, maternal obesity is becoming an increasingly frequent high-risk obstetrical situation. Obese women have a higher incidence of pregnancy complications (gestational diabetes, hypertension, toxaemia, etc.) and of adverse fetal outcomes (macrosomia, neural tube defects, perinatal mortality). Cesarean section is more frequent in obese women, resulting in a higher risk of anaesthetic and post-operative complications. Maternofetal complications are proportional to the degree of obesity, and even moderate overweight amplifies the risk. Long-term complications include worsening of maternal obesity, maternal type 2 diabetes, and childhood obesity and metabolic disorders. Before conception, these patients should receive tailored weight-loss advice and be screened for obesity complications. Food intake during pregnancy should be tailored to achieve the minimum maternal weight gain required for normal fetal growth. Long-term follow-up is required to prevent worsening of maternal obesity after delivery, and the child's growth curve should be closely watched