Abstract

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

Highlights

  • FIGO’s Committee Guideline for the Management of Pre­ pregnancy, Pregnancy, and Postpartum Obesity (Table 1) reviews good clinical practice recommendations (Table 2–4) from previously published international documents

  • It serves as a practical resource to support obstetricians and gynecologists in the management of wileyonlinelibrary.com/journal/ijgo

  • Obesity increases the risk of noncommunicable diseases (NCDs), such as type 2 diabetes and cardiovascular disease, which contribute to over 70% of global deaths annually[5,6]

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Summary

| EXECUTIVE SUMMARY

Obstetricians and gynecologists are well positioned to influence popu‐ lation health through maternity and women’s health services. All women should receive information on diet and lifestyle appropriate to their gestation including nutrient supplements, weight management, and regular physical activity. All women with obesity should be encouraged to lose weight post partum with emphasis on healthy diet, breastfeeding if possible, and regu‐ lar moderate physical activity They should be advised of the importance of long‐term follow‐up as they and their children are at increased risk for noncommunicable diseases. Primary care services should support women of childbearing age with weight management before pregnancy and body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) should be measured. Women with obesity in early pregnancy should receive specialist advice on the benefits of breastfeeding and appropriate antenatal and postnatal support for breastfeeding initiation and maintenance.

| INTRODUCTION
Moderate intensity and appropriate exercise should be encouraged during pregnancy
Women with obesity should continue to take folic acid dur‐ ing at least the first trimester
All pregnant women with a BMI ≥30 should be screened for gestational diabetes in early pregnancy
B.4.11. Women with a BMI ≥40 should be referred to an anesthe‐ tist for assessment in the antenatal period
B.4.14. Establish venous access in early labor for women with a BMI ≥40 and consider a second cannula
B.4.17. Postoperative pharmacologic thromboprophylaxis should be prescribed based on maternal weight
Women with obesity should be offered further dietary advice to support postpartum weight management
| ETHICAL CONSIDERATIONS FOR OBESITY MANAGEMENT
Women with obesity should be counselled on the most appropriate form of postnatal contraception based on BMI
| SUMMARY
Findings
46. ACOG practice bulletin No 156

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