Influence of obesity on reproductive health before and during pregnancy

Most women with obesity are fertile, although obesity increases the risk of infertility. This review describes the influence of obesity on reproductive health before and during pregnancy and postpartum. It also discusses the multidisciplinary management of obesity during a woman’s reproductive perio...

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Main Authors: A. Konwisser, O. Korytko
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2022-12-01
Series:Mìžnarodnij Endokrinologìčnij Žurnal
Subjects:
Online Access:https://iej.zaslavsky.com.ua/index.php/journal/article/view/1224
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author A. Konwisser
O. Korytko
author_facet A. Konwisser
O. Korytko
author_sort A. Konwisser
collection DOAJ
description Most women with obesity are fertile, although obesity increases the risk of infertility. This review describes the influence of obesity on reproductive health before and during pregnancy and postpartum. It also discusses the multidisciplinary management of obesity during a woman’s reproductive period based on the scientific literature on the subject published from January 2015 to March 2022. Obesity is a risk factor for endometrial hyperplasia and cancer. Women with obesity have a lower response to ovarian stimulation. In ovulation induction treatments, there is less likelihood of ovulation using clomiphene citrate, higher doses of gonadotropins are required and a smaller number of follicles develop. Women with polycystic ovary syndrome (PCOS) have a higher likelihood of obesity (prevalence ranging from 14 to 75 % depending on the population studied), longitudinal weight gain and abdominal obesity compared to women without PCOS. Obesity and PCOS are two conditions with complex pathophysiologies and it is not clear which one of them acts as a cause or as a consequence of the other. The pregnancies of women with obesity are at increased risk of different complications, including gestational diabetes, hypertensive disease of pregnancy (gestational hypertension or preeclampsia), foetal malformations, prematurity, both spontaneous and induced by other complications, Caesarean delivery, postpartum haemorrhage and thromboembolism. Primary care practice includes health promotion and prevention actions, and it is often the first point of contact between a woman and her partner and the healthcare service before they conceive. Primary care is therefore responsible for providing this new family with quality prenatal care with preventive activities prior to pregnancy. In relation to obesity, this situation provides the opportunity for effective communication with women and their families about weight goals at this stage of life, the importance of weight loss prior to pregnancy, maximum weight gain during pregnancy and postpartum weight loss to reduce the risk of adverse outcomes in current and future pregnancies.
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spelling doaj.art-8fe2fc27a7354db3a52101f4dcf9a4942023-06-04T19:42:12ZengZaslavsky O.Yu.Mìžnarodnij Endokrinologìčnij Žurnal2224-07212307-14272022-12-0118844645010.22141/2224-0721.18.8.2022.12241222Influence of obesity on reproductive health before and during pregnancyA. Konwisser0O. Korytko1https://orcid.org/0000-0002-3510-469XKRH Klinikum Grosburgwel, Frauenklinik, Hannover, GermanyDanylo Halytsky Lviv National Medical University, Lviv, UkraineMost women with obesity are fertile, although obesity increases the risk of infertility. This review describes the influence of obesity on reproductive health before and during pregnancy and postpartum. It also discusses the multidisciplinary management of obesity during a woman’s reproductive period based on the scientific literature on the subject published from January 2015 to March 2022. Obesity is a risk factor for endometrial hyperplasia and cancer. Women with obesity have a lower response to ovarian stimulation. In ovulation induction treatments, there is less likelihood of ovulation using clomiphene citrate, higher doses of gonadotropins are required and a smaller number of follicles develop. Women with polycystic ovary syndrome (PCOS) have a higher likelihood of obesity (prevalence ranging from 14 to 75 % depending on the population studied), longitudinal weight gain and abdominal obesity compared to women without PCOS. Obesity and PCOS are two conditions with complex pathophysiologies and it is not clear which one of them acts as a cause or as a consequence of the other. The pregnancies of women with obesity are at increased risk of different complications, including gestational diabetes, hypertensive disease of pregnancy (gestational hypertension or preeclampsia), foetal malformations, prematurity, both spontaneous and induced by other complications, Caesarean delivery, postpartum haemorrhage and thromboembolism. Primary care practice includes health promotion and prevention actions, and it is often the first point of contact between a woman and her partner and the healthcare service before they conceive. Primary care is therefore responsible for providing this new family with quality prenatal care with preventive activities prior to pregnancy. In relation to obesity, this situation provides the opportunity for effective communication with women and their families about weight goals at this stage of life, the importance of weight loss prior to pregnancy, maximum weight gain during pregnancy and postpartum weight loss to reduce the risk of adverse outcomes in current and future pregnancies.https://iej.zaslavsky.com.ua/index.php/journal/article/view/1224obesitypregnancyreproductive healthpolycystic ovary syndromemanagement
spellingShingle A. Konwisser
O. Korytko
Influence of obesity on reproductive health before and during pregnancy
Mìžnarodnij Endokrinologìčnij Žurnal
obesity
pregnancy
reproductive health
polycystic ovary syndrome
management
title Influence of obesity on reproductive health before and during pregnancy
title_full Influence of obesity on reproductive health before and during pregnancy
title_fullStr Influence of obesity on reproductive health before and during pregnancy
title_full_unstemmed Influence of obesity on reproductive health before and during pregnancy
title_short Influence of obesity on reproductive health before and during pregnancy
title_sort influence of obesity on reproductive health before and during pregnancy
topic obesity
pregnancy
reproductive health
polycystic ovary syndrome
management
url https://iej.zaslavsky.com.ua/index.php/journal/article/view/1224
work_keys_str_mv AT akonwisser influenceofobesityonreproductivehealthbeforeandduringpregnancy
AT okorytko influenceofobesityonreproductivehealthbeforeandduringpregnancy