Smith, S. A., Hulsey, T., & Goodnight, W. (2008). Journal of Obstetric, Gynecologic & Neonatal Nursing, 37, 176-184.
The purpose of this review was to identify physiologic and psychological pregnancy outcomes associated with maternal obesity and to identify effective interventions. The authors conducted a literature search using the keywords obesity, weight gain, body image, pregnancy weight gain, pregnancy obesity complications, pre-eclampsia, and gestational diabetes. Articles published within the last 10 years and indexed in CINAHL, Medline ERIC, and Psychinfo were included if they met the authors' criteria for scientific merit and research outcomes. A total of 54 articles was reviewed. The authors noted that a large proportion of women either fail to achieve recommended body mass index (BMI)-specific weight gain or exceed the BMI-specific weight gain recommended by the Institutes of Medicine. Obesity increases the risk for gestational diabetes, hypertension, cardiac disease, osteoarthritis, breast cancer, endometrial cancer, and colon cancer. Pregnancy-related complications due to obesity include increased risk for cesarean birth, pre-eclampsia, postpartum infection, preterm birth, neural tube defects, and either fetal macrosomia or very low birthweight. Persistence of excessive weight gain after pregnancy also may lead to an increased BMI during a subsequent pregnancy. Many women also may experience alterations in body image. No body of research provides evidence of the long-term effectiveness of interventions that target weight control during pregnancy and the postpartum period. It is important for nurses to provide individualized counseling and support to pregnant women who are obese. Women need to be aware of the long-term effects related to excessive weight gain during pregnancy. Additional well-designed intervention studies are needed to document the long-term effects of maternal obesity.
Judith A. Lewis