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JOGC

Directive clinique No 391 - Grossesse et obésité maternelle Partie 1 : Préconception et soins prénataux

      RÉSUMÉ

      Objectif

      La présente directive clinique aborde les aspects essentiels des soins prénataux chez les femmes atteintes d'obésité. La partie 1 porte sur la préconception et les soins prénataux. La partie 2 porte sur la planification en équipe de l'accouchement et les soins post-partum.

      Utilisateurs concernés

      Tous les fournisseurs de soins de santé (obstétriciens, médecins de famille, sages-femmes, infirmières, anesthésiologistes) qui prodiguent des soins relatifs à la grossesse auprès de femmes atteintes d'obésité.

      Population cible

      Femmes atteintes d'obésité qui sont enceintes ou prévoient le devenir.

      Données probantes

      Des recherches ont été menées en consultant les ressources de Statistique Canada, de Medline et de Cochrane Library en vue d'en tirer la littérature relativement aux effets de l'obésité durant la grossesse sur les soins prénataux et intrapartum, la morbidité et la mortalité maternelles, l'anesthésie obstétricale ainsi que sur la morbidité et la mortalité périnatales. Seuls les résultats de revues systématiques, d'essais cliniques randomisés ou comparatifs et d’études observationnelles ont été retenus. Aucune restriction de date ou de langue n'a été employée. Les recherches ont été mises à jour régulièrement, et les résultats ont été incorporés à la directive clinique jusqu'en septembre 2018. Nous avons également tenu compte de la littérature grise (non publiée) obtenue sur les sites Web d'organismes d’évaluation des technologies de la santé et d'autres organismes pertinents, dans des collections de directives cliniques et des registres d'essais cliniques, et auprès d'associations nationales et internationales de médecins spécialistes.

      Méthodes de validation

      Le contenu et les recommandations ont été rédigés et acceptés par les auteurs. Les membres du comité de médecine fœto-maternelle ont ensuite passé en revue le contenu et formulé des commentaires aux fins d'examen. Enfin, le conseil d'administration de la Société des obstétriciens et gynécologues du Canada (SOGC) a approuvé la publication de la version définitive de la directive. Les points de désaccord ont été abordés lors de réunions pour enfin arriver à un consensus. La qualité des données et des recommandations a été déterminée à l'aide des critères d’évaluation décrits par le Groupe d’étude canadien sur les soins de santé préventifs.

      Avantages, préjudice et coûts

      La mise en place des recommandations des présentes directives peut améliorer la reconnaissance des fournisseurs de soins obstétricaux relativement aux problèmes qui touchent les personnes enceintes atteintes d'obésité, notamment au moyen de stratégies de prévention clinique; de la communication entre l’équipe de soins de santé, la patiente et la famille; et de la planification de l’équipement et des ressources humaines. Il est à espérer que les organismes régionaux, provinciaux et fédéraux participeront à la formation et au soutien en matière de soins coordonnés pour les personnes enceintes atteintes d'obésité.

      Mise à jour de la directive clinique

      Les directives de la SOGC sont automatiquement passées en revue 5 ans après leur publication. Les auteurs peuvent toutefois proposer une autre date de réévaluation s'ils croient qu'une période de 5 ans est trop courte ou trop longue en fonction de leurs connaissances du sujet à titre d'experts en la matière.

      Promoteurs

      La présente directive a été élaborée à l'aide de ressources financées par la SOGC.

      DÉCLARATIONS SOMMAIRES

      • 1
        L'obésité maternelle comporte des risques maternels et fœtaux (II-2).
      • 2
        Les options relatives à la gestion et la perte de poids pendant la grossesse sont limitées (II-2).
      • 3
        Les directives peuvent aider à formuler des recommandations personnalisées par rapport à la prise de poids gestationnel et à l'apport calorique et nutritionnel durant la grossesse (II-2).
      • 4
        L'obésité maternelle est un facteur de risque de la macrosomie fœtale (II-2).
      • 5
        En contexte d'obésité maternelle, on observe une réduction de la précision de l'imagerie fœtale aux fins de datation de la grossesse, d’évaluation anatomique et d'estimation du poids fœtal (II-2).
      • 6
        L'obésité maternelle augmente le risque de mortinaissance (II-1).
      • 7
        Les grossesses multiples présentent des risques supplémentaires lorsqu'elles sont compliquées par une obésité maternelle (II-2).
      • 8
        Quoiqu'elle procure généralement des bienfaits à la mère et au fœtus, la chirurgie bariatrique avant la grossesse présente des morbidités rares et graves pendant la grossesse (II-1).

      RECOMMANDATIONS

      • 1
        Les stratégies de gestion de poids avant la grossesse peuvent intégrer des approches médicales ou chirurgicales en plus de l'alimentation et de l'activité physique. Les stratégies appliquées avant la grossesse peuvent apporter des bienfaits pour la santé même lors des grossesses subséquentes (III- B).
      • 2
        Comme l'obésité comporte des risques médicaux, il est justifié de vérifier avant la grossesse la présence de certaines affections cardiovasculaires, pulmonaires, urinaires, endocriniens et cutanés, en plus de l'apnée obstructive du sommeil (II-3 B).
      • 3
        La supplémentation en acide folique durant les 3 mois précédant la conception est justifiée étant donné les risques accrus d'anomalies congénitales du cœur fœtal et du tube neural en cas d'obésité maternelle (II-2 A).
      • 4
        Il est recommandé d'intégrer officiellement la surveillance du gain de poids gestationnel et les approches de gestion du gain de poids gestationnel dans les soins prénataux habituels (III- A).
      • 5
        Il existe suffisamment de données pour soutenir le rôle de l'activité physique pendant la grossesse (I- A).
      • 6
        Il existe suffisamment de données pour soutenir la supplémentation en acide folique (au moins 0,4 mg) et en vitamine D (400 UI) durant la grossesse (II-2 A).
      • 7
        Il est possible de limiter la macrosomie fœtale au moyen d'un bon contrôle du gain de poids gestationnel maternel (II-2 A).
      • 8
        En raison du risque accru de mortinaissance en cas d'obésité maternelle, il est suggéré d'augmenter la surveillance du bien-être fœtal au troisième trimestre si l'on observe une diminution des mouvements fœtaux (II-3).
      • 9
        Pour prévenir la pré-éclampsie, il convient d'envisager l'administration d'aspirine à des fins prophylactiques chez les femmes atteintes d'obésité qui présentent d'autres facteurs de risque (I- A).
      • 10
        l est recommandé d'envisager l'accouchement à 39-40 semaines de grossesse chez les femmes dont l'indice de masse corporelle est de 40 kg/m2 ou plus en raison du risque accru de mortinaissance (II-2 A).
      • 11
        Chez les femmes atteintes d'obésité, les grossesses multiples nécessitent une surveillance accrue. Il peut également s'avérer bénéfique de consulter un spécialiste en médecine fœto-maternelle, en particulier en cas de grossesse monochoriale (II-2 A).
      • 12
        Il peut s'avérer bénéfique de consulter un spécialiste en médecine fœto-maternelle en cas de grossesse après une intervention chirurgicale bariatrique étant donné le potentiel de morbidités maternelles importantes mais rares (III- B).

      Mots clés

      Abbreviations:

      AOS (apnée obstructive du sommeil), GPG (gain de poids gestationnel), IMC (indice de masse corporelle)
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      RÉFÉRENCES

        • Government of Canada
        Population by year, by province and territory.
        in: Canada S Population by year, by province and territory. Government of Canada, Ottawa2017
      1. Government of Canada. Body mass index, overweight or obese, self-reported, adult, by age group and sex. In: Government of Canada, editor. Ottawa: Government of Canada; 2016.

        • Lashen H
        • Fear K
        • Sturdee DW
        Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study.
        Hum Reprod. 2004; 19: 1644-1646
        • Callaway LK
        • Prins JB
        • Chang AM
        • et al.
        The prevalence and impact of overweight and obesity in an Australian obstetric population.
        Med J Aust. 2006; 184: 56-59
        • Sebire NJ
        • Jolly M
        • Harris JP
        • et al.
        Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London.
        Int J Obes Relat Metab Disord. 2001; 25: 1175-1182
        • Gaillard R
        • Durmus B
        • Hofman A
        • et al.
        Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy.
        Obesity (Silver Spring). 2013; 21: 1046-1055
        • Leddy MA
        • Power ML
        • Schulkin J
        The impact of maternal obesity on maternal and fetal health.
        Rev Obstet Gynecol. 2008; 1: 170-178
        • Bianco AT
        • Smilen SW
        • Davis Y
        • et al.
        Pregnancy outcome and weight gain recommendations for the morbidly obese woman.
        Obstet Gynecol. 1998; 91: 97-102
        • Cedergren MI
        Maternal morbid obesity and the risk of adverse pregnancy outcome.
        Obstet Gynecol. 2004; 103: 219-224
        • Larsen TB
        • Sorensen HT
        • Gislum M
        • et al.
        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
        • Vasudevan C
        • Renfrew M
        • McGuire W
        Fetal and perinatal consequences of maternal obesity.
        Arch Dis Child Fetal Neonatal Ed. 2011; 96: F378-F382
        • Jacobsen AF
        • Skjeldestad FE
        • Sandset PM
        Ante- and postnatal risk factors of venous thrombosis: a hospital-based case-control study.
        J Thromb Haemost. 2008; 6: 905-912
        • Metwally M
        • Ong KJ
        • Ledger WL
        • et al.
        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
        • Usha Kiran TS
        • Hemmadi S
        • Bethel J
        • et al.
        Outcome of pregnancy in a woman with an increased body mass index.
        BJOG. 2005; 112: 768-772
        • Johansson S
        • Villamor E
        • Altman M
        • et al.
        Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden.
        BMJ. 2014; 349: g6572
        • Shah A
        • Kenny L
        • Sands J
        Maternal obesity and risk of stillbirth and neonatal death.
        J Matern Fetal Neonatal Med. 2006; 19: 88
        • Kristensen J
        • Vestergaard M
        • Wisborg K
        • et al.
        Pre-pregnancy weight and the risk of stillbirth and neonatal death.
        BJOG. 2005; 112: 403-408
        • Persson M
        • Cnattingius S
        • Villamor E
        • et al.
        Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.
        BMJ. 2017; 357: j2563
      2. World Health Organization (WHO). BMI Classification Geneva: WHO; 2006. Disponible à : http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi Consulté le 11 mai 2019.

        • Ramsay JE
        • Ferrell WR
        • Crawford L
        • et al.
        Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways.
        J Clin Endocrinol Metab. 2002; 87: 4231-4237
        • Gibson LY
        • Byrne SM
        • Davis EA
        • et al.
        The role of family and maternal factors in childhood obesity.
        Med J Aust. 2007; 186: 591-595
        • Moos MK
        • Dunlop AL
        • Jack BW
        • et al.
        Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age.
        Am J Obstet Gynecol. 2008; 199: S280-S289
        • Hanson M
        • Barker M
        • Dodd JM
        • et al.
        Interventions to prevent maternal obesity before conception, during pregnancy, and post partum.
        Lancet Diabetes Endocrinol. 2017; 5: 65-76
        • Villamor E
        • Cnattingius S
        Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study.
        Lancet. 2006; 368: 1164-1170
        • Cohen JB
        • Cohen DL
        Cardiovascular and renal effects of weight reduction in obesity and the metabolic syndrome.
        Curr Hypertens Rep. 2015; 17: 34
        • Morales E
        • Praga M
        The effect of weight loss in obesity and chronic kidney disease.
        Curr Hypertens Rep. 2012; 14: 170-176
        • Wing RR
        • Lang W
        • Wadden TA
        • et al.
        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
        • Anderson JW
        • Konz EC
        Obesity and disease management: effects of weight loss on comorbid conditions.
        Obes Res. 2001; 9: 326s-334s
        • Wing RR
        • Koeske R
        • Epstein LH
        • et al.
        Long-term effects of modest weight loss in type II diabetic patients.
        Arch Intern Med. 1987; 147: 1749-1753
        • Davies GAL
        • Maxwell C
        • McLeod L
        No. 239-Obesity in Pregnancy.
        J Obstet Gynaecol Can. 2018 Aug; 40 (PubMed): e630-e639https://doi.org/10.1016/j.jogc.2018.05.018
        • Berti C
        • Biesalski HK
        • Gartner R
        • et al.
        Micronutrients in pregnancy: current knowledge and unresolved questions.
        Clin Nutr. 2011; 30: 689-701
        • Steegers-Theunissen RP
        • Twigt J
        • Pestinger V
        • et al.
        The periconceptional period, reproduction and long-term health of offspring: the importance of one-carbon metabolism.
        Hum Reprod Update. 2013; 19: 640-655
        • Calder PC
        • Ahluwalia N
        • Brouns F
        • et al.
        Dietary factors and low-grade inflammation in relation to overweight and obesity.
        Br J Nutr. 2011; 106: S5-78
        • Lau DC
        • Douketis JD
        • Morrison KM
        • et al.
        2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary].
        CMAJ. 2007; 176: S1-13
        • McNeely W
        • Benfield P
        Orlistat.
        Drugs. 1998; 56 (discussion 50): 241-249
        • Finer N
        • James WP
        • Kopelman PG
        • et al.
        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
        • Broom I
        • Wilding J
        • Stott P
        • et al.
        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
        • Hollander PA
        • Elbein SC
        • Hirsch IB
        • et al.
        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
        • Woods SC
        • D'Alessio DA
        Central control of body weight and appetite.
        J Clin Endocrinol Metab. 2008; 93: S37-S50
        • Delgado-Aros S
        • Kim DY
        • Burton DD
        • et al.
        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
        • Pi-Sunyer X
        • Astrup A
        • Fujioka K
        • et al.
        A randomized, controlled trial of3.0 mg of liraglutide in weight management.
        N Engl J Med. 2015; 373: 11-22
        • Davies MJ
        • Bergenstal R
        • Bode B
        • et al.
        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.
        2019 (Disponible à :) (Consulté le 10 avril 19)
        • Angrisani L
        • Santonicola A
        • Iovino P
        • et al.
        Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014.
        Obes Surg. 2017; 27: 2279-2289
        • Abenhaim HA
        • Alrowaily N
        • Czuzoj-Shulman N
        • et al.
        Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women.
        J Matern Fetal Neonatal Med. 2016; 29: 3596-3601
        • Alvarenga ES
        • Lo Menzo E
        • Szomstein S
        • et al.
        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
        • Karamanakos SN
        • Vagenas K
        • Kalfarentzos F
        • et al.
        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
        • Bohdjalian A
        • Langer FB
        • Shakeri-Leidenmuhler S
        • et al.
        Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin.
        Obes Surg. 2010; 20: 535-540
        • Cottam D
        • Qureshi FG
        • Mattar SG
        • et al.
        Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity.
        Surg Endosc. 2006; 20: 859-863
        • Schauer PR
        • Ikramuddin S
        • Gourash W
        • et al.
        Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.
        Ann Surg. 2000; 232: 515-529
        • Sugerman HJ
        • Kellum JM
        • Engle KM
        • et al.
        Gastric bypass for treating severe obesity.
        Am J Clin Nutr. 1992; 55: 560s-566s
        • Wittgrove AC
        • Clark GW
        Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up.
        Obes Surg. 2000; 10: 233-239
        • Poitou Bernert C
        • Ciangura C
        • Coupaye M
        • et al.
        Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment.
        Diabetes Metab. 2007; 33: 13-24
        • Wax JR
        • Pinette MG
        • Cartin A
        • et al.
        Female reproductive issues following bariatric surgery.
        Obstet Gynecol Surv. 2007; 62: 595-604
        • Tice JA
        • Karliner L
        • Walsh J
        • et al.
        Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures.
        Am J Med. 2008; 121: 885-893
        • Buchwald H
        • Avidor Y
        • Braunwald E
        • et al.
        Bariatric surgery: a systematic review and meta-analysis.
        JAMA. 2004; 292: 1724-1737
        • Hutter MM
        • Schirmer BD
        • Jones DB
        • et al.
        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
        • Bar-Zohar D
        • Azem F
        • Klausner J
        • et al.
        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
        • Eerdekens A
        • Debeer A
        • Van Hoey G
        • et al.
        Maternal bariatric surgery: adverse outcomes in neonates.
        Eur J Pediatr. 2010; 169: 191-196
        • Martin LF
        • Finigan KM
        • Nolan TE
        Pregnancy after adjustable gastric banding.
        Obstet Gynecol. 2000; 95: 927-930
        • Badreldin N
        • Kuller J
        • Rhee E
        • et al.
        Pregnancy management after bariatric surgery.
        Obstet Gynecol Surv. 2016; 71: 361-368
        • Yi XY
        • Li QF
        • Zhang J
        • et al.
        A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery.
        Int J Gynaecol Obstet. 2015; 130: 3-9
        • Willis K
        • Lieberman N
        • Sheiner E
        Pregnancy and neonatal outcome after bariatric surgery.
        Best Pract Res Clin Obstet Gynaecol. 2015; 29: 133-144
        • Galazis N
        • Docheva N
        • Simillis C
        • et al.
        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
        • Parent B
        • Martopullo I
        • Weiss NS
        • et al.
        Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications.
        JAMA Surg. 2017; 152: 1-8
        • Rueda-Clausen CF
        • Ogunleye AA
        • Sharma AM
        Health benefits of long-term weight-loss maintenance.
        Annu Rev Nutr. 2015; 35: 475-516
        • Meldrum DR
        • Morris MA
        • Gambone JC
        Obesity pandemic: causes, consequences, and solutions-but do we have the will?.
        Fertil Steril. 2017; 107: 833-839
        • Menke A
        • Casagrande S
        • Geiss L
        • et al.
        Prevalence of and trends in diabetes among adults in the United States, 1988-2012.
        JAMA. 2015; 314: 1021-1029
        • Jensen MD
        • Ryan DH
        • Apovian CM
        • et al.
        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
        • Mokdad AH
        • Ford ES
        • Bowman BA
        • et al.
        Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.
        JAMA. 2003; 289: 76-79
        • Maxwell C
        • Farine D
        Pregnancy and obesity.
        de Gruyter BD, Berlin2017
        • Louis J
        • Auckley D
        • Miladinovic B
        • et al.
        Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women.
        Obstet Gynecol. 2012; 120: 1085-1092
        • Louis JM
        • Mogos MF
        • Salemi JL
        • et al.
        Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009.
        Sleep. 2014; 37: 843-849
        • Senaratna CV
        • Perret JL
        • Matheson MC
        • et al.
        Validity of the Berlin questionnaire in detecting obstructive sleep apnea: a systematic review and meta-analysis.
        Sleep Med Rev. 2017; 36: 116-124
        • Ankumah NE
        • Sibai BM
        Chronic hypertension in pregnancy: diagnosis, management, and outcomes.
        Clin Obstet Gynecol. 2017; 60: 206-214
        • Wilson RD
        • Wilson RD
        • Audibert F
        • et al.
        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
        • Chiswick C
        • Reynolds RM
        • Denison F
        • et al.
        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
        • Syngelaki A
        • Nicolaides KH
        • Balani J
        • et al.
        Metformin versus placebo in obese pregnant women without diabetes mellitus.
        N Engl J Med. 2016; 374: 434-443
        • Elmaraezy A
        • Abushouk AI
        • Emara A
        • et al.
        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
        • Bartsch E
        • Medcalf KE
        • Park AL
        • et al.
        Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies.
        BMJ. 2016; 353: i1753
        • Roberge S
        • Giguere Y
        • Villa P
        • et al.
        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
        • D'Souza R
        • Kingdom J
        Preeclampsia.
        CMAJ. 2016; 188: 1178
        • Kapadia MZ
        • Park CK
        • Beyene J
        • et al.
        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
        • Institute of Medicine
        Weight gain during pregnancy: reexamining the guidelines.
        National Academy Press, Washington, DC2009: 1-13
        • Swank ML
        • Marshall NE
        • Caughey AB
        • et al.
        Pregnancy outcomes in the super obese, stratified by weight gain above and below institute of medicine guidelines.
        Obstet Gynecol. 2014; 124: 1105-1110
        • Sui Z
        • Turnbull DA
        • Dodd JM
        Overweight and obese women's perceptions about making healthy change during pregnancy: a mixed method study.
        Matern Child Health J. 2013; 17: 1879-1887
        • Shulman R
        • Kottke M
        Impact of maternal knowledge of recommended weight gain in pregnancy on gestational weight gain.
        Am J Obstet Gynecol. 2016; 214: 754.e1-754.e7
        • de Jersey SJ
        • Nicholson JM
        • Callaway LK
        • et al.
        An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy.
        BMC Pregnancy Childbirth. 2013; 13: 115
        • Olander EK
        • Atkinson L
        Obese women's reasons for not attending a weight management service during pregnancy.
        Acta Obstet Gynecol Scand. 2013; 92: 1227-1230
        • Ferraro ZM
        • Boehm KS
        • Gaudet LM
        • et al.
        Counseling about gestational weight gain and healthy lifestyle during pregnancy: Canadian maternity care providers’ self-evaluation.
        Int J Womens Health. 2013; 5: 629-636
        • Chuang CH
        • Stengel MR
        • Hwang SW
        • et al.
        Behaviours of overweight and obese women during pregnancy who achieve and exceed recommended gestational weight gain.
        Obes Res Clin Pract. 2014; 8: e577-e583
        • Harrison CL
        • Teede HJ
        • Lombard CB
        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
        • Gay CL
        • Richoux SE
        • Beebe KR
        • et al.
        Sleep disruption and duration in late pregnancy is associated with excess gestational weight gain among overweight and obese women.
        Birth. 2017; 44: 173-180
        • Redman LM
        • Gilmore LA
        • Breaux J
        • et al.
        Effectiveness of SmartMoms, a novel ehealth intervention for management of gestational weight gain: randomized controlled pilot trial.
        JMIR Mhealth Uhealth. 2017; 5: e133
        • Mottola MF
        • Giroux I
        • Gratton R
        • et al.
        Nutrition and exercise prevent excess weight gain in overweight pregnant women.
        Med Sci Sports Exerc. 2010; 42: 265-272
        • Kominiarek MA
        • Rajan P
        Nutrition recommendations in pregnancy and lactation.
        Med Clin. 2016; 100: 1199-1215
        • Chen LW
        • Aris IM
        • Bernard JY
        • et al.
        Associations of maternal macronutrient intake during pregnancy with infant BMI peak characteristics and childhood BMI.
        Am J Clin Nutr. 2017; 105: 705-713
        • Renault KM
        • Carlsen EM
        • Norgaard K
        • et al.
        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
        • Leung CW
        • Laraia BA
        • Coleman-Phox K
        • et al.
        Sugary beverage and food consumption, and leukocyte telomere length maintenance in pregnant women.
        Eur J Clin Nutr. 2016; 70: 1086-1088
        • Cervantes-Rodriguez M
        • Martinez-Gomez M
        • Cuevas E
        • et al.
        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
        • Wilson RD
        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
        • Vanderlelie J
        • Scott R
        • Shibl R
        • et al.
        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
        • Masho SW
        • Bassyouni A
        • Cha S
        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
        • Kennedy D
        • Koren G
        Identifying women who might benefit from higher doses of folic acid in pregnancy.
        Can Fam Physician. 2012; 58: 394-397
        • Farah N
        • Kennedy C
        • Turner C
        • et al.
        Maternal obesity and pre-pregnancy folic acid supplementation.
        Obes Facts. 2013; 6: 211-215
        • Karlsson T
        • Andersson L
        • Hussain A
        • et al.
        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
        • National Institute for Health and Care Excellence (NICE)
        Antenatal Care (NICE Clinical Guideline 62).
        NICE, London2008 (Disponible à :) (Consulté le 11 mai 2019)
        • Tijerina-Saenz A
        • Martinez-Garza NE
        • Ramirez-Lopez E
        • et al.
        Iron status and dietary intakes of iron in normal-weight and obese young Mexican women.
        Nutr Hosp. 2015; 31: 2412-2418
        • World Health Organization
        Food and Agricultural Orgamization of the United Nations.
        Guidelines for the Evaluation of Probiotics in Food, London, ON2002 (Disponible à :) (Consulté le 19 avril, 2019)
        • Khorsan R
        • Crawford C
        • Ives JA
        • et al.
        The effect of omega-3 fatty acids on biomarkers of inflammation: a rapid evidence assessment of the literature.
        Mil Med. 2014; 179: 2-60
        • Denison FC
        • Weir Z
        • Carver H
        • et al.
        Physical activity in pregnant women with class III obesity: a qualitative exploration of attitudes and behaviours.
        Midwifery. 2015; 31: 1163-1167
        • Ruiz JR
        • Perales M
        • Pelaez M
        • et al.
        Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial.
        Mayo Clin Proc. 2013; 88: 1388-1397
        • Padmapriya N
        • Bernard JY
        • Liang S
        • et al.
        Associations of physical activity and sedentary behavior during pregnancy with gestational diabetes mellitus among Asian women in Singapore.
        BMC Pregnancy Childbirth. 2017; 17: 364
        • Barakat R
        • Pelaez M
        • Cordero Y
        • et al.
        Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial.
        Am J Obstet Gynecol. 2016; 214: 649.e1-649.e8
        • Elliott-Sale KJ
        • Barnett CT
        • Sale C
        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
        • Garnaes KK
        • Morkved S
        • Salvesen O
        • et al.
        Exercise training and weight gain in obese pregnant women: a randomized controlled trial (ETIP trial).
        PLoS Med. 2016; 13e1002079
        • Magro-Malosso ER
        • Saccone G
        • Di Mascio D
        • et al.
        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
        • Adamo KB
        • Ferraro ZM
        • Goldfield G
        • et al.
        The Maternal Obesity Management (MOM) trial protocol: a lifestyle intervention during pregnancy to minimize downstream obesity.
        Contemp Clin Trials. 2013; 35: 87-96
        • Mottola MF
        Physical activity and maternal obesity: cardiovascular adaptations, exercise recommendations, and pregnancy outcomes.
        Nutr Rev. 2013; 71: S31-S36
        • Davenport MH
        • Charlesworth S
        • Vanderspank D
        • et al.
        Development and validation of exercise target heart rate zones for overweight and obese pregnant women.
        Appl Physiol Nutr Metab. 2008; 33: 984-989
        • McParlin C
        • Robson SC
        • Tennant PW
        • et al.
        Objectively measured physical activity during pregnancy: a study in obese and overweight women.
        BMC Pregnancy Childbirth. 2010; 10: 76
        • Canadian Society for Exercise Physiology (CSEP)
        PARmed-X for pregnancy.
        CSEP, Ottawa2015 (Disponible à :) (Consulté le 19 avril, 2019)
        • Foxcroft KF
        • Rowlands IJ
        • Byrne NM
        • et al.
        Exercise in obese pregnant women: the role of social factors, lifestyle and pregnancy symptoms.
        BMC Pregnancy Childbirth. 2011; 11: 4
        • Seneviratne SN
        • McCowan LM
        • Cutfield WS
        • et al.
        Exercise in pregnancies complicated by obesity: achieving benefits and overcoming barriers.
        Am J Obstet Gynecol. 2015; 212: 442-449
        • Bell R
        • Tennant PW
        • McParlin C
        • et al.
        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
        • St-Laurent A
        • Mony M
        • Mathieu M
        • et al.
        Validation of the Fitbit Zip and Fitbit Flex with pregnant women in free-living conditions.
        J Med Eng Technol. 2018; 42: 259-264
        • Renault KM
        • Norgaard K
        • Nilas L
        • et al.
        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
        • Mottola MF
        • Davenport MH
        • Ruchat SM
        • Davies GA
        • Poitras V
        • Gray C
        • Jaramillo A
        • Barrowman N
        • Adamo KB
        • Duggan M
        • Barakat R
        • Chilibeck P
        • Fleming K
        • Forte M
        • Korolnek J
        • Nagpal T
        • Slater L
        • Stirling D
        • Zehr L
        No. 367-2019 Canadian Guideline for Physical Activity throughout Pregnancy.
        J Obstet Gynaecol Can. 2018 Nov; 40 (Epub 2018 Oct 5. PubMed): 1528-1537https://doi.org/10.1016/j.jogc.2018.07.001
        • Wallace JM
        • Horgan GW
        • Bhattacharya S
        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
        • Zhang C
        • Hediger ML
        • Albert PS
        • et al.
        Association of maternal obesity with longitudinal ultrasonographic measures of fetal growth: findings fromthe NICHD fetal growth studies-singletons.
        JAMA Pediatr. 2018; 172: 24-31
        • Dai RX
        • He XJ
        • Hu CL
        Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis.
        Arch Gynecol Obstet. 2018; 297: 139-145
        • Lindsay KL
        • Brennan L
        • Rath A
        • et al.
        Gestational weight gain in obese pregnancy: impact on maternal and foetal metabolic parameters and birthweight.
        J Obstet Gynaecol. 2018; 38: 60-65
        • Lauring JR
        • Gupta M
        • Kunselman AR
        • et al.
        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
        • Yao R
        • Park BY
        • Foster SE
        • et al.
        The association between gestational weight gain and risk of stillbirth: a population-based cohort study.
        Ann Epidemiol. 2017; 27 (638–44.e1)
        • Benacerraf B
        The use of obstetrical ultrasound in the obese gravida.
        Semin Perinatol. 2013; 37: 345-347
        • Bak GS
        • Sperling L
        • Kallen K
        • et al.
        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
        • Simic M
        • Wahlin IA
        • Marsal K
        • et al.
        Maternal obesity is a potential source of error in mid-trimester ultrasound estimation of gestational age.
        Ultrasound Obstet Gynecol. 2010; 35: 48-53
        • Hildebrand E
        • Kallen B
        • Josefsson A
        • et al.
        Maternal obesity and risk of Down syndrome in the offspring.
        Prenat Diagn. 2014; 34: 310-315
        • Aagaard-Tillery KM
        • Flint Porter T
        • Malone FD
        • et al.
        Influence of maternal BMI on genetic sonography in the FaSTER trial.
        Prenat Diagn. 2010; 30: 14-22
        • Tsai LJ
        • Ho M
        • Pressman EK
        • et al.
        Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida.
        Prenat Diagn. 2010; 30: 821-826
        • Thornburg LL
        • Mulconry M
        • Post A
        • et al.
        Fetal nuchal translucency thickness evaluation in the overweight and obese gravida.
        Ultrasound Obstet Gynecol. 2009; 33: 665-669
        • Yared E
        • Dinsmoor MJ
        • Endres LK
        • et al.
        Obesity increases the risk of failure of noninvasive prenatal screening regardless of gestational age.
        Am J Obstet Gynecol. 2016; 215: 370.e1-370.e6
        • Stothard KJ
        • Tennant PW
        • Bell R
        • et al.
        Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis.
        JAMA. 2009; 301: 636-650
        • Best KE
        • Tennant PW
        • Bell R
        • et al.
        Impact of maternal body mass index on the antenatal detection of congenital anomalies.
        BJOG. 2012; 119: 1503-1511
        • Dashe JS
        • McIntire DD
        • Twickler DM
        Maternal obesity limits the ultrasound evaluation of fetal anatomy.
        J Ultrasound Med. 2009; 28: 1025-1030
        • Maxwell C
        • Glanc P
        Imaging and obesity: a perspective during pregnancy.
        AJR Am J Roentgenol. 2011; 196: 311-319
        • Hendler I
        • Blackwell SC
        • Treadwell MC
        • et al.
        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
        • Chung JH
        • Pelayo R
        • Hatfield TJ
        • et al.
        Limitations of the fetal anatomic survey via ultrasound in the obese obstetrical population.
        J Matern Fetal Neonatal Med. 2012; 25: 1945-1949
        • Nevo O
        • Brown R
        • Glanc P
        • et al.
        No. 352-technical update: the role of early comprehensive fetal anatomy ultrasound examination.
        J Obstet Gynaecol Can. 2017; 39: 1203-1211
        • Glanc P
        • D'Souza R
        • Parrish J
        • et al.
        Should an early anatomy ultrasound scan be offered routinely to obese pregnant women?.
        J Obstet Gynaecol Can. 2018; 40: 1288-1294
        • Sparks TN
        • Cheng YW
        • McLaughlin B
        • et al.
        Fundal height: a useful screening tool for fetal growth?.
        J Matern Fetal Neonatal Med. 2011; 24: 708-712
        • Ahmadzia HK
        • Thomas SM
        • Dude AM
        • et al.
        Prediction of birthweight from third-trimester ultrasound in morbidly obese women.
        Am J Obstet Gynecol. 2014; 211: 431.e1-431.e7
        • American College of Obstetricians and Gynecologists
        Practice bulletin no. 173: fetal macrosomia.
        Obstet Gynecol. 2016; 128: e195
        • Bradford BF
        • Thompson JMD
        • Heazell AEP
        • et al.
        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
        • Brown R
        • Higgins LE
        • Johnstone ED
        • et al.
        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
        • Brocato B
        • Lewis D
        • Mulekar M
        • et al.
        Obesity's impact on intrapartum electronic fetal monitoring.
        J Matern Fetal Neonatal Med. 2019; 32: 92-94
        • Harper LM
        • Jauk VC
        • Owen J
        • et al.
        The utility of ultrasound surveillance of fluid and growth in obese women.
        Am J Obstet Gynecol. 2014; 211: 524.e1-524.e8
        • Sarno L
        • Maruotti GM
        • Saccone G
        • et al.
        Maternal body mass index influences umbilical artery Doppler velocimetry in physiologic pregnancies.
        Prenat Diagn. 2015; 35: 125-128
        • Kim YH
        • Lee HJ
        • Shin JE
        • et al.
        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
        • LeFevre ML
        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
        • Magee LA
        • Pels A
        • Helewa M
        • et al.
        Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary.
        J Obstet Gynaecol Can. 2014; 36: 416-438
        • Hofmeyr GJ
        • Lawrie TA
        • Atallah AN
        • et al.
        Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.
        Cochrane Database Syst Rev. 2014; (Cd001059)
        • Santamaria A
        • Di Benedetto A
        • Petrella E
        • et al.
        Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial.
        J Matern Fetal Neonatal Med. 2016; 29: 3234-3237
        • Matarrelli B
        • Vitacolonna E
        • D'Angelo M
        • et al.
        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
        • Bodnar LM
        • Parks WT
        • Perkins K
        • et al.
        Maternal prepregnancy obesity and cause-specific stillbirth.
        Am J Clin Nutr. 2015; 102: 858-864
        • Avagliano L
        • Marconi AM
        • Romagnoli S
        • et al.
        Abnormal spiral arteries modification in stillbirths: the role of maternal prepregnancy body mass index.
        J Matern Fetal Neonatal Med. 2012; 25: 2789-2792
        • Warland J
        • Mitchell EA
        A triple risk model for unexplained late stillbirth.
        BMC Pregnancy Childbirth. 2014; 14: 142
        • Bodnar LM
        • Siega-Riz AM
        • Simhan HN
        • et al.
        Severe obesity, gestational weight gain, and adverse birth outcomes.
        Am J Clin Nutr. 2010; 91: 1642-1648
        • Gill L
        • Holbert M
        Computational model for timing of delivery in an obese population.
        J Matern Fetal Neonatal Med. 2018; 31: 469-473
        • Al-Obaidly S
        • Parrish J
        • Murphy KE
        • et al.
        Maternal pre-gravid body mass index and obstetric outcomes in twin gestations.
        J Perinatol. 2014; 34: 425-428
        • Lucovnik M
        • Tul N
        • Verdenik I
        • et al.
        Risk factors for preeclampsia in twin pregnancies: a population-based matched case-control study.
        J Perinat Med. 2012; 40: 379-382
        • Shamshirsaz AA
        • Haeri S
        • Ravangard SF
        • et al.
        Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies.
        J Matern Fetal Neonatal Med. 2014; 27: 552-556
        • Luke B
        Nutrition and multiple gestation.
        Semin Perinatol. 2005; 29: 349-354
        • Lucovnik M
        • Blickstein I
        • Verdenik I
        • et al.
        Maternal obesity in singleton versus twin gestations: a population-based matched case–control study.
        J Matern Fetal Neonatal Med. 2015; 28: 623-625
        • Dickey RP
        • Xiong X
        • Xie Y
        • et al.
        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
        • Ryan HM
        • Morrison JJ
        • Breathnach FM
        • et al.
        The influence of maternal body mass index on fetal weight estimation in twin pregnancy.
        Am J Obstet Gynecol. 2014; 210: 350.e1-350.e6
        • Salihu HM
        • Alio AP
        • Belogolovkin V
        • et al.
        Prepregnancy obesity and risk of stillbirth in viable twin gestations.
        Obesity (Silver Spring). 2010; 18: 1795-1800
        • Narayanan RP
        • Syed AA
        Pregnancy following bariatric surgery-medical complications and management.
        Obes Surg. 2016; 26: 2523-2529