Benefits, Harms, and Costs
- 1Maternal obesity carries both maternal and fetal risks (II-2).
- 2There are limited options for weight loss and management during pregnancy (II-2).
- 3Guidelines can assist with individualized recommendations regarding maternal gestational weight gain and calorie and nutrient intake during pregnancy (II-2).
- 4Maternal obesity is a risk factor for fetal macrosomia (II-2).
- 5The accuracy of fetal imaging for pregnancy dating, anatomical assessment, and fetal weight estimates is reduced in the setting of maternal obesity (II-2).
- 6Stillbirth is more common with maternal obesity (II-1).
- 7Multiple gestations carry additional risks in pregnancies complicated by maternal obesity (II-2).
- 8Weight loss surgery before pregnancy, while generally conferring benefits to mother and fetus, also carries rare and serious morbidity during gestation (II-1).
- 1Weight management strategies prior to pregnancy may include dietary, exercise, medical, and surgical approaches. When pursued before pregnancy, health benefits may carry forward into future pregnancies (III B).
- 2As obesity carries many medical risks, assessment for conditions of the cardiac, pulmonary, renal, endocrine, and skin systems, as well as obstructive sleep apnea, is warranted in the pre-pregnancy period (II-3 B).
- 3Folic acid supplementation in the 3 months prior to conception is warranted given the increased risks of congenital abnormalities of the fetal heart and neural tube related to maternal obesity (II-2 A).
- 4It is recommended that both monitoring of gestational weight gain and approaches for gestational weight gain management be formally integrated into routine prenatal care (III A).
- 5There is good evidence to support the role of exercise in pregnancy (I A).
- 6There is good evidence to support supplementation with folic acid (at least 0.4 mg) and vitamin D (400 IU) during pregnancy (II-2 A).
- 7Fetal macrosomia may be altered by well-controlled maternal gestational weight gain (II-2 A).
- 8Increased fetal surveillance for well-being is suggested in the third trimester if the reduced fetal movements are reported, given the increased rate of stillbirth (II-3).
- 9Aspirin prophylaxis can be recommended for women with obesity when other risk factors are present for the prevention of preeclampsia (I A).
- 10It is recommended that delivery be considered at 39–40 weeks gestation for women with a body mass index of 40 kg/m2 or greater given the increased rate of stillbirth (II-2 A).
- 11Multiple gestations in women with obesity require increased surveillance and may benefit from consultation with a Maternal-Fetal Medicine consultant, especially in the setting of monochorionic gestations (II-2 A).
- 12Pregnancy after weight loss surgery may benefit from Maternal-Fetal Medicine consultation given the potential for significant albeit rare maternal morbidity (III B).
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- Population by year, by province and territory.Government of Canada, In: The Government of Canada, editor. Ottawa2017
- Body mass index, overweight or obese, self-reported, adult, by age group and sex.Government of Canada, In: Government of Canada, editor. Ottawa2016
- Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study.Hum Reprod. 2004; 19: 1644-1646
- The prevalence and impact of overweight and obesity in an Australian obstetric population.Med J Aust. 2006; 184: 56-59
- Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London.Int J Obes Relat Metab Disord. 2001; 25: 1175-1182
- Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy.Obesity (Silver Spring). 2013; 21: 1046-1055
- The impact of maternal obesity on maternal and fetal health.Rev Obstet Gynecol. 2008; 1: 170-178
- Pregnancy outcome and weight gain recommendations for the morbidly obese woman.Obstet Gynecol. 1998; 91: 97-102
- Maternal morbid obesity and the risk of adverse pregnancy outcome.Obstet Gynecol. 2004; 103: 219-224
- Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case-control study.Thromb Res. 2007; 120: 505-509
- Fetal and perinatal consequences of maternal obesity.Arch Dis Child Fetal Neonatal Ed. 2011; 96: F378-F382
- Ante- and postnatal risk factors of venous thrombosis: a hospital-based case-control study.J Thromb Haemost. 2008; 6: 905-912
- Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence.Fertil Steril. 2008; 90: 714-726
- Outcome of pregnancy in a woman with an increased body mass index.BJOG. 2005; 112: 768-772
- Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden.BMJ. 2014; 349: g6572
- Maternal obesity and risk of stillbirth and neonatal death.J Matern Fetal Neonatal Med. 2006; 19: 88
- Pre-pregnancy weight and the risk of stillbirth and neonatal death.BJOG. 2005; 112: 403-408
- Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.BMJ. 2017; 357: j2563
- BMI Classification.WHO, Geneva2006 (Available at:)http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi(Accessed May 11, 2019)
- Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways.J Clin Endocrinol Metab. 2002; 87: 4231-4237
- The role of family and maternal factors in childhood obesity.Med J Aust. 2007; 186: 591-595
- Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age.Am J Obstet Gynecol. 2008; 199: S280-S289
- Interventions to prevent maternal obesity before conception, during pregnancy, and post partum.Lancet Diabetes Endocrinol. 2017; 5: 65-76
- Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study.Lancet. 2006; 368: 1164-1170
- Cardiovascular and renal effects of weight reduction in obesity and the metabolic syndrome.Curr Hypertens Rep. 2015; 17: 34
- The effect of weight loss in obesity and chronic kidney disease.Curr Hypertens Rep. 2012; 14: 170-176
- Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes.Diabetes Care. 2011; 34: 1481-1486
- Obesity and disease management: effects of weight loss on comorbid conditions.Obes Res. 2001; 9: 326s-334s
- Long-term effects of modest weight loss in type II diabetic patients.Arch Intern Med. 1987; 147: 1749-1753
- No. 239-Obesity in pregnancy.Int J Obstet Gynaecol Can. 2018; 40: e630-e639
- Micronutrients in pregnancy: current knowledge and unresolved questions.Clin Nutr. 2011; 30: 689-701
- The periconceptional period, reproduction and long-term health of offspring: the importance of one-carbon metabolism.Hum Reprod Update. 2013; 19: 640-655
- Dietary factors and low-grade inflammation in relation to overweight and obesity.Br J Nutr. 2011; 106: S5-78
- 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary].CMAJ. 2007; 176: S1-13
- Orlistat.Drugs. 1998; 56 (discussion 50): 241-249
- One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor.Int J Obes Relat Metab Disord. 2000; 24: 306-313
- Randomised trial of the effect of orlistat on body weight and cardiovascular disease risk profile in obese patients: UK Multimorbidity Study.Int J Clin Pract. 2002; 56: 494-499
- Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study.Diabetes Care. 1998; 21: 1288-1294
- Central control of body weight and appetite.J Clin Endocrinol Metab. 2008; 93: S37-S50
- Effect of GLP-1 on gastric volume, emptying, maximum volume ingested, and postprandial symptoms in humans.Am J Physiol Gastrointest Liver Physiol. 2002; 282: G424-G431
- A randomized, controlled trial of 3.0 mg of liraglutide in weight management.N Engl J Med. 2015; 373: 11-22
- Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial.JAMA. 2015; 314: 687-699
American Society for Metabolic and Bariatric Surgery. Story of Obesity Surgery. Available at: https://asmbs.org/resources/story-of-obesity-surgery. Accessed on April 19, 2019.
- Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014.Obes Surg. 2017; 27: 2279-2289
- Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women.J Matern Fetal Neonatal Med. 2016; 29: 3596-3601
- Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program.Surg Endosc. 2016; 30: 2673-2678
- Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study.Ann Surg. 2008; 247: 401-407
- Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin.Obes Surg. 2010; 20: 535-540
- Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity.Surg Endosc. 2006; 20: 859-863
- Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.Ann Surg. 2000; 232: 515-529
- Gastric bypass for treating severe obesity.Am J Clin Nutr. 1992; 55: 560s-566s
- Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up.Obes Surg. 2000; 10: 233-239
- Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment.Diabetes Metab. 2007; 33: 13-24
- Female reproductive issues following bariatric surgery.Obstet Gynecol Surv. 2007; 62: 595-604
- Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures.Am J Med. 2008; 121: 885-893
- Bariatric surgery: a systematic review and meta-analysis.JAMA. 2004; 292: 1724-1737
- First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass.Ann Surg. 2011; 254 (discussion 20–2): 410-420
- Pregnancy after laparoscopic adjustable gastric banding: perinatal outcome is favorable also for women with relatively high gestational weight gain.Surg Endosc. 2006; 20: 1580-1583
- Maternal bariatric surgery: adverse outcomes in neonates.Eur J Pediatr. 2010; 169: 191-196
- Pregnancy after adjustable gastric banding.Obstet Gynecol. 2000; 95: 927-930
- Pregnancy management after bariatric surgery.Obstet Gynecol Surv. 2016; 71: 361-368
- A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery.Int J Gynaecol Obstet. 2015; 130: 3-9
- Pregnancy and neonatal outcome after bariatric surgery.Best Pract Res Clin Obstet Gynaecol. 2015; 29: 133-144
- Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis.Eur J Obstet Gynecol Reprod Biol. 2014; 181: 45-53
- Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications.JAMA Surg. 2017; 152: 1-8
- Health benefits of long-term weight-loss maintenance.Annu Rev Nutr. 2015; 35: 475-516
- Obesity pandemic: causes, consequences, and solutions-but do we have the will?.Fertil Steril. 2017; 107: 833-839
- Prevalence of and trends in diabetes among adults in the United States, 1988-2012.JAMA. 2015; 314: 1021-1029
- 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society.J Am Coll Cardiol. 2014; 63: 2985-3023
- Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.JAMA. 2003; 289: 76-79
- Pregnancy and obesity.de Gruyter BD, Berlin2017
- Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women.Obstet Gynecol. 2012; 120: 1085-1092
- Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009.Sleep. 2014; 37: 843-849
- Validity of the Berlin questionnaire in detecting obstructive sleep apnea: a systematic review and meta-analysis.Sleep Med Rev. 2017; 36: 116-124
- Chronic hypertension in pregnancy: diagnosis, management, and outcomes.Clin Obstet Gynecol. 2017; 60: 206-214
- Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies.J Obstet Gynaecol Can. 2015; 37: 534-552
- Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial.Lancet Diabetes Endocrinol. 2015; 3: 778-786
- Metformin versus placebo in obese pregnant women without diabetes mellitus.N Engl J Med. 2016; 374: 434-443
- Effect of metformin on maternal and neonatal outcomes in pregnant obese non-diabetic women: a meta-analysis.Int J Reprod Biomed (Yazd). 2017; 15: 461-470
- Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies.BMJ. 2016; 353: i1753
- Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia: a systematic review and meta-analysis.Am J Perinatol. 2012; 29: 551-556
- Preeclampsia.CMAJ. 2016; 188: 1178
- Weight loss instead of weight gain within the guidelines in obese women during pregnancy: a systematic review and meta-analyses of maternal and infant outcomes.PLoS One. 2015; 10e0132650
- Weight gain during pregnancy: reexamining the guidelines.National Academy Press, Washington, DC2009: 1-13
- Pregnancy outcomes in the super obese, stratified by weight gain above and below institute of medicine guidelines.Obstet Gynecol. 2014; 124: 1105-1110
- Overweight and obese women's perceptions about making healthy change during pregnancy: a mixed method study.Matern Child Health J. 2013; 17: 1879-1887
- Impact of maternal knowledge of recommended weight gain in pregnancy on gestational weight gain.Am J Obstet Gynecol. 2016; 214: 754.e1-754.e7
- An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy.BMC Pregnancy Childbirth. 2013; 13: 115
- Obese women's reasons for not attending a weight management service during pregnancy.Acta Obstet Gynecol Scand. 2013; 92: 1227-1230
- Counseling about gestational weight gain and healthy lifestyle during pregnancy: Canadian maternity care providers’ self-evaluation.Int J Womens Health. 2013; 5: 629-636
- Behaviours of overweight and obese women during pregnancy who achieve and exceed recommended gestational weight gain.Obes Res Clin Pract. 2014; 8: e577-e583
- How effective is self-weighing in the setting of a lifestyle intervention to reduce gestational weight gain and postpartum weight retention?.Aust N Z J Obstet Gynaecol. 2014; 54: 382-385
- Sleep disruption and duration in late pregnancy is associated with excess gestational weight gain among overweight and obese women.Birth. 2017; 44: 173-180
- Effectiveness of SmartMoms, a novel ehealth intervention for management of gestational weight gain: randomized controlled pilot trial.JMIR Mhealth Uhealth. 2017; 5: e133
- Nutrition and exercise prevent excess weight gain in overweight pregnant women.Med Sci Sports Exerc. 2010; 42: 265-272
- Nutrition recommendations in pregnancy and lactation.Med Clin. 2016; 100: 1199-1215
- Associations of maternal macronutrient intake during pregnancy with infant BMI peak characteristics and childhood BMI.Am J Clin Nutr. 2017; 105: 705-713
- Intake of sweets, snacks and soft drinks predicts weight gain in obese pregnant women: detailed analysis of the results of a randomised controlled trial.PLoS One. 2015; 10e0133041
- Sugary beverage and food consumption, and leukocyte telomere length maintenance in pregnant women.Eur J Clin Nutr. 2016; 70: 1086-1088
- Sugared water consumption by adult offspring of mothers fed a protein-restricted diet during pregnancy results in increased offspring adiposity: the second hit effect.Br J Nutr. 2014; 111: 616-624
- Pre-conceptional vitamin/folic acid supplementation 2007: the use of folic acid in combination with a multivitamin supplement for the prevention of neural tube defects and other congenital anomalies.J Obstet Gynaecol Can. 2007; 29: 1003-1013
- First trimester multivitamin/mineral use is associated with reduced risk of pre-eclampsia among overweight and obese women.Matern Child Nutr. 2016; 12: 339-348
- Pre-pregnancy obesity and non-adherence to multivitamin use: findings from the National Pregnancy Risk Assessment Monitoring System (2009-2011).BMC Pregnancy Childbirth. 2016; 16: 210
- Identifying women who might benefit from higher doses of folic acid in pregnancy.Can Fam Physician. 2012; 58: 394-397
- Maternal obesity and pre-pregnancy folic acid supplementation.Obes Facts. 2013; 6: 211-215
- Lower vitamin D status in obese compared with normal-weight women despite higher vitamin D intake in early pregnancy.Clin Nutr. 2015; 34: 892-898
- Antenatal Care (NICE Clinical Guideline 62).NICE, London2008 (Available at:)Accessed May 11, 2019)
- Iron status and dietary intakes of iron in normal-weight and obese young Mexican women.Nutr Hosp. 2015; 31: 2412-2418
- Guidelines for the Evaluation of Probiotics in Food. London, ON: 2002.2002 (Available at:)http://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdfDate accessed: April 19, 2019
- The effect of omega-3 fatty acids on biomarkers of inflammation: a rapid evidence assessment of the literature.Mil Med. 2014; 179: 2-60
- Physical activity in pregnant women with class III obesity: a qualitative exploration of attitudes and behaviours.Midwifery. 2015; 31: 1163-1167
- Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial.Mayo Clin Proc. 2013; 88: 1388-1397
- Associations of physical activity and sedentary behavior during pregnancy with gestational diabetes mellitus among Asian women in Singapore.BMC Pregnancy Childbirth. 2017; 17: 364
- Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial.Am J Obstet Gynecol. 2016; 214: 649.e1-649.e8
- Systematic review of randomised controlled trials on exercise interventions for weight management during pregnancy and up to one year postpartum among normal weight, overweight and obese women.Pregnancy Hypertens. 2014; 4: 234
- Exercise training and weight gain in obese pregnant women: a randomized controlled trial (ETIP trial).PLoS Med. 2016; 13e1002079
- Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials.Acta Obstet Gynecol Scand. 2017; 96: 263-273
- The Maternal Obesity Management (MOM) trial protocol: a lifestyle intervention during pregnancy to minimize downstream obesity.Contemp Clin Trials. 2013; 35: 87-96
- Physical activity and maternal obesity: cardiovascular adaptations, exercise recommendations, and pregnancy outcomes.Nutr Rev. 2013; 71: S31-S36
- Development and validation of exercise target heart rate zones for overweight and obese pregnant women.Appl Physiol Nutr Metab. 2008; 33: 984-989
- Objectively measured physical activity during pregnancy: a study in obese and overweight women.BMC Pregnancy Childbirth. 2010; 10: 76
- PARmed-X for pregnancy.CSEP, Ottawa2015 (Available at:)http://www.csep.ca/cmfiles/publications/parq/parmed-xpreg.pdfDate accessed: April 19, 2019
- Exercise in obese pregnant women: the role of social factors, lifestyle and pregnancy symptoms.BMC Pregnancy Childbirth. 2011; 11: 4
- Exercise in pregnancies complicated by obesity: achieving benefits and overcoming barriers.Am J Obstet Gynecol. 2015; 212: 442-449
- Measuring physical activity in pregnancy: a comparison of accelerometry and self-completion questionnaires in overweight and obese women.Eur J Obstet Gynecol Reprod Biol. 2013; 170: 90-95
- Validation of the Fitbit Zip and Fitbit Flex with pregnant women in free-living conditions.J Med Eng Technol. 2018; 42: 259-264
- The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women.Am J Obstet Gynecol. 2014; 210: 134.e1-134.e9
- No. 367-2019 Canadian Guideline for Physical Activity throughout Pregnancy.J Obstet Gynaecol Can. 2018; 40: 1528-1537
- Placental weight and efficiency in relation to maternal body mass index and the risk of pregnancy complications in women delivering singleton babies.Placenta. 2012; 33: 611-618
- Association of maternal obesity with longitudinal ultrasonographic measures of fetal growth: findings from the NICHD fetal growth studies-singletons.JAMA Pediatr. 2018; 172: 24-31
- Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis.Arch Gynecol Obstet. 2018; 297: 139-145
- Gestational weight gain in obese pregnancy: impact on maternal and foetal metabolic parameters and birthweight.J Obstet Gynaecol. 2018; 38: 60-65
- Identification of small for gestational age by population-based and customized growth charts in newborns of obese and normal-weight primiparous women.J Matern Fetal Neonatal Med. 2016; 29: 3570-3574
- The association between gestational weight gain and risk of stillbirth: a population-based cohort study.Ann Epidemiol. 2017; 27 (638–44.e1)
- The use of obstetrical ultrasound in the obese gravida.Semin Perinatol. 2013; 37: 345-347
- Prospective population-based cohort study of maternal obesity as a source of error in gestational age estimation at 11-14 weeks.Acta Obstet Gynecol Scand. 2016; 95: 1281-1287
- Maternal obesity is a potential source of error in mid-trimester ultrasound estimation of gestational age.Ultrasound Obstet Gynecol. 2010; 35: 48-53
- Maternal obesity and risk of Down syndrome in the offspring.Prenat Diagn. 2014; 34: 310-315
- Influence of maternal BMI on genetic sonography in the FaSTER trial.Prenat Diagn. 2010; 30: 14-22
- Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida.Prenat Diagn. 2010; 30: 821-826
- Fetal nuchal translucency thickness evaluation in the overweight and obese gravida.Ultrasound Obstet Gynecol. 2009; 33: 665-669
- Obesity increases the risk of failure of noninvasive prenatal screening regardless of gestational age.Am J Obstet Gynecol. 2016; 215: 370.e1-370.e6
- Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis.JAMA. 2009; 301: 636-650
- Impact of maternal body mass index on the antenatal detection of congenital anomalies.BJOG. 2012; 119: 1503-1511
- Maternal obesity limits the ultrasound evaluation of fetal anatomy.J Ultrasound Med. 2009; 28: 1025-1030
- Imaging and obesity: a perspective during pregnancy.AJR Am J Roentgenol. 2011; 196: 311-319
- Does advanced ultrasound equipment improve the adequacy of ultrasound visualization of fetal cardiac structures in the obese gravid woman?.Am J Obstet Gynecol. 2004; 190 (discussion 9–20): 1616-1619
- Limitations of the fetal anatomic survey via ultrasound in the obese obstetrical population.J Matern Fetal Neonatal Med. 2012; 25: 1945-1949
- No. 352-technical update: the role of early comprehensive fetal anatomy ultrasound examination.J Obstet Gynaecol Can. 2017; 39: 1203-1211
- Should an early anatomy ultrasound scan be offered routinely to obese pregnant women?.J Obstet Gynaecol Can. 2018; 40: 1288-1294
- Fundal height: a useful screening tool for fetal growth?.J Matern Fetal Neonatal Med. 2011; 24: 708-712
- Prediction of birthweight from third-trimester ultrasound in morbidly obese women.Am J Obstet Gynecol. 2014; 211: 431.e1-431.e7
- Practice bulletin no. 173: fetal macrosomia.Obstet Gynecol. 2016; 128: e195
- Understanding the associations and significance of fetal movements in overweight or obese pregnant women: a systematic review.Acta Obstet Gynecol Scand. 2018; 97: 13-24
- Maternal perception of fetal movements in late pregnancy is affected by type and duration of fetal movement.J Matern Fetal Neonatal Med. 2016; 29: 2145-2150
- Obesity's impact on intrapartum electronic fetal monitoring.J Matern Fetal Neonatal Med. 2019; 32: 92-94
- The utility of ultrasound surveillance of fluid and growth in obese women.Am J Obstet Gynecol. 2014; 211: 524.e1-524.e8
- Maternal body mass index influences umbilical artery Doppler velocimetry in physiologic pregnancies.Prenat Diagn. 2015; 35: 125-128
- The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity.Obes Res Clin Pract. 2015; 9: 374-381
- Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement.Ann Intern Med. 2014; 161: 819-826
- Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary.J Obstet Gynaecol Can. 2014; 36: 416-438
- Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.Cochrane Database Syst Rev. 2014; Cd001059
- Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial.J Matern Fetal Neonatal Med. 2016; 29: 3234-3237
- Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial.J Matern Fetal Neonatal Med. 2013; 26: 967-972
- Maternal prepregnancy obesity and cause-specific stillbirth.Am J Clin Nutr. 2015; 102: 858-864
- Abnormal spiral arteries modification in stillbirths: the role of maternal prepregnancy body mass index.J Matern Fetal Neonatal Med. 2012; 25: 2789-2792
- A triple risk model for unexplained late stillbirth.BMC Pregnancy Childbirth. 2014; 14: 142
- Severe obesity, gestational weight gain, and adverse birth outcomes.Am J Clin Nutr. 2010; 91: 1642-1648
- Computational model for timing of delivery in an obese population.J Matern Fetal Neonatal Med. 2018; 31: 469-473
- Maternal pre-gravid body mass index and obstetric outcomes in twin gestations.J Perinatol. 2014; 34: 425-428
- Risk factors for preeclampsia in twin pregnancies: a population-based matched case-control study.J Perinat Med. 2012; 40: 379-382
- Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies.J Matern Fetal Neonatal Med. 2014; 27: 552-556
- Nutrition and multiple gestation.Semin Perinatol. 2005; 29: 349-354
- Maternal obesity in singleton versus twin gestations: a population-based matched case–control study.J Matern Fetal Neonatal Med. 2015; 28: 623-625
- Effect of maternal height and weight on risk for preterm singleton and twin births resulting from IVF in the United States, 2008-2010.Am J Obstet Gynecol. 2013; 209: 349.e1-349.e6
- The influence of maternal body mass index on fetal weight estimation in twin pregnancy.Am J Obstet Gynecol. 2014; 210: 350.e1-350.e6
- Prepregnancy obesity and risk of stillbirth in viable twin gestations.Obesity (Silver Spring). 2010; 18: 1795-1800
- Pregnancy following bariatric surgery-medical complications and management.Obes Surg. 2016; 26: 2523-2529
This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well-documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the publisher.
All people have the right and responsibility to make informed decisions about their care in partnership with their health care providers. In order to facilitate informed choice, patients should be provided with information and support that is evidence-based, culturally appropriate, and tailored to their needs.
This guideline was written using language that places women at the centre of care. The SOGC is committed to respecting the rights of all people—including transgender, gender non-binary, and intersex people—for whom the guideline may apply. We encourage health care providers to engage in respectful conversation with patients regarding their gender identity as a critical part of providing safe and appropriate care. The values, beliefs, and individual needs of each patient and their family should be sought and the final decision about the care and treatment options chosen by the patient should be respected.