Pregnant Women Living with Obesity: A Cross-Sectional Observational Study of Dietary Quality and Pregnancy Outcomes

Margaret Charnley,Lisa Newson,Julie Abayomi,Andrew Weeks

doi:10.3390/nu13051652

Margaret Charnley, Lisa Newson + Show 2 more

Open Access

https://doi.org/10.3390/nu13051652

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Abstract

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

Highlights

In England, the majority of adults are overweight or obese [1], and within the pregnant population, less than half are recorded as having a healthy weight, with over a fifth of pregnant women living with obesity [2]
Jointly state that overweight and obesity during pregnancy significantly influence maternal mortality, with 49% of deaths occurring in women who are overweight (BMI ≥ 25 kg/m2 ), and 27% of deaths occur in women living with obesity (BMI ≥ 30 kg/m2 ) [5]
This study opportunistically sampled participants through the Fit for Birth Trial (FFB) cohort, recruiting those women referred into obstetric services for additional antenatal support as deemed a high-risk pregnancy and an ideal target audience for dietary assessment

Summary

Introduction

In England, the majority of adults are overweight or obese [1], and within the pregnant population, less than half are recorded as having a healthy weight, with over a fifth of pregnant women living with obesity [2]. The World Health Organisation [6] acknowledges that good nutrition during early life is the most important factor in tackling both the double burden of disease and health inequalities worldwide. They assert that poor nutrition during early life, including pregnancy, can have detrimental, short-term and long-lasting effects. Maternal nutritional intake is an important determinant of Gestational Weight Gain (GWG), which influence maternal and child health outcomes

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