BMI >= 25 during pregnancy

Research shows that having a BMI of 25 or higher (which is considered overweight) can increase certain risks during pregnancy, delivery, and after birth. Here’s what you need to know:

During Pregnancy

• Miscarriages: The risk of losing the pregnancy is higher.

• Birth Defects: There is a greater chance of the baby having problems such as issues with the brain and spine (neural tube defects), cleft lip or palate, water on the brain (hydrocephalus), missing or shortened limbs, or heart defects.

  • Note: It can also be harder to get clear ultrasound images if the mother has a higher BMI. Sometimes, using both internal (transvaginal) and external (transabdominal) scans at 12 and 16 weeks can help doctors see the baby better.

• Preterm Birth: Babies are more likely to be born early (before 37 weeks).

• Large Baby: Babies may be larger than average, which can make vaginal delivery more difficult.

• Stillbirth: The risk of the baby dying before birth is higher, especially after 37 weeks and in older mothers.

• Other Health Problems: There is a higher chance of developing conditions like:

  • Diabetes that starts during pregnancy (gestational diabetes)

  • High blood pressure (gestational hypertension)

  • Pre-eclampsia (a serious blood pressure condition)

  • Anxiety and depression

  • Blood clots in the veins (venous thromboembolism), which may require regular injections to prevent clots, especially if there are other risk factors.

Because of these risks, close monitoring by your healthcare team during pregnancy is very important.

During Delivery

• Labour Problems: Labour may take longer, and there is a higher risk of complications such as:

  • The baby’s shoulder getting stuck during birth (shoulder dystocia)

  • Needing to start labour with medication (induction), which may not always work

  • Needing a Caesarean section (C-section)

  • Higher risk of infection after delivery

• Caesarean Section: Women with a higher BMI are more likely to need a C-section than those with a lower BMI.

After Delivery

• Wound Infections: There is a higher risk of infection at the site of a C-section, especially if BMI is 30 or above (or 27 or above for Asian women). Giving antibiotics during delivery and using special wound dressings can help lower this risk.

• Blood Clots: The risk of blood clots in the legs or lungs is higher. This risk can be reduced by getting up and moving as soon as possible after delivery, wearing special stockings, and using blood-thinning injections if needed.

• Baby’s Health: Babies may have low blood sugar or trouble breathing after birth, which sometimes means they need to spend a short time in the intensive care unit for monitoring and treatment.

What Can You Do?

• Weight Gain: The Institute of Medicine in the US recommends that women with a higher BMI should aim to gain only 5–9 kg (about 11–20 pounds) during pregnancy. Some experts suggest even less (0–5 kg) if BMI is 30 or higher.

• Healthy Habits:

  • Eat a balanced diet and avoid too many carbohydrates (like sugar and white bread).

  • Stay physically active with regular exercise, as recommended by your doctor.

If you have a higher BMI and are pregnant or planning to become pregnant, talk to your healthcare provider about how to manage your health and reduce risks for you and your baby.