Abstract
BackgroundObesity is associated with impaired fertility and pregnancy complications, and preconception weight loss may improve some of these outcomes. The purpose of this study was to evaluate the quality and effectiveness of Maternal Fetal Medicine (MFM) preconception consults for obese women.MethodsWe performed a retrospective chart review examining 162 consults at an academic medical center from 2008 to 2014. The main outcome measures included consultation content – e.g. discussion of obesity-related pregnancy complications, screening for comorbidities, and referrals for weight loss interventions – and weight loss.ResultsScreening for diabetes and hypertension occurred in 48% and 51% of consults, respectively. Discussion of obesity-related pregnancy complications was documented in 96% of consults. During follow-up (median 11 months), 27% of patients saw a nutritionist, 6% saw a provider for a medically supervised weight loss program, and 6% underwent bariatric surgery. The median weight change was a loss of 0.6% body weight.ConclusionsIn this discovery cohort, a large proportion of MFM preconception consultations lacked appropriate screening for obesity-related comorbidities. While the vast majority of consultations included a discussion of potential pregnancy complications, relatively few patients achieved significant weight loss. More emphasis is needed on weight loss resources and delaying pregnancy to achieve weight loss goals.
Highlights
Obesity is associated with impaired fertility and pregnancy complications, and preconception weight loss may improve some of these outcomes
In light of the adverse effects of obesity and potential benefits of weight loss, some obese women are referred to Maternal Fetal Medicine (MFM) for a preconception consultation
If the patient had a known diagnosis of hypertension or documentation of a blood pressure in the MFM consultation note, we considered hypertension screening ‘done.’ We considered discussion of obesity-related pregnancy complications to have occurred if the MFM note stated that this subject was discussed
Summary
Obesity is associated with impaired fertility and pregnancy complications, and preconception weight loss may improve some of these outcomes. The purpose of this study was to evaluate the quality and effectiveness of Maternal Fetal Medicine (MFM) preconception consults for obese women. Obesity is associated with impaired fertility in women, including decreased rates of pregnancy, higher rates of miscarriage, and decreased rates of live birth with both natural conception and assisted reproductive technology (ART) [2,3,4,5,6,7,8]. In light of the adverse effects of obesity and potential benefits of weight loss, some obese women are referred to Maternal Fetal Medicine (MFM) for a preconception consultation. Preconception MFM consultations for obese women have not been previously
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
