Doctors no longer advise women to eat for two during their pregnancies

Doctors no longer advise women to eat for two during their pregnancies as new research shows that overeating during this time can impact the health of their babies adversely.

Only a pregnant woman knows what it's like to be told repeatedly by both her mother and mother-in-law to eat "enough for two." It turns out that this advice may be wrong after all: New studies have shown that a high calorie diet could affect the gender, and more importantly, the health of the baby. According to this study, the high fat, high carbohydrate diet of pregnant mice impacted almost 2,000 genes in the developing offspring, including those involved in kidney function and smell.

Doctors in the city agree that a pregnant woman who overeats can harm her unborn child by exposing it to a host of health problems. "Pregnancy is the time when a women needs to exercise control on her diet and eat judiciously. The first three months is the time to have extra folic acid along with a balanced diet and a diet rich in calcium and iron is recommended for the rest of the pregnancy. But most women these days eat fatty foods which leads to all sorts of problems," says Dr Mala Srivastava, consultant gynaecologist, Sir Ganga Ram Hospital.

According to experts, the offspring of mothers who overeat are at risk for liver and pancreas damage, both of which can contribute to early onset obesity and diabetes. Another study by Rockefeller University scientists reported in The Journal of Neuroscience says that short-term exposure to a high-fat diet in utero produces permanent neurons in the foetal brain that later increase the appetite for fat. "A diabetic mother can pass on her health condition to the child. However, there are no established clinical studies which say that children of obese mothers run at a risk of early onset of obesity. Though mothers do pass on their unhealthy eating habits to their children and such children take after their parents," says Dr Mala.

FRAUGHT WITH PROBLEMS

For an obese woman, the experience of pregnancy - starting right from the time of conception to labour is fraught with problems. Even a simple ultrasound scan becomes a tedious affair for an obese mother as the excessive layer of fat makes it difficult to detect the foetus and monitor the heart rate.

Last year a country-wide study conducted on 4,621 women above the age of 35, in areas like cities such as Kolkata, Kochi and Jaipur reported high prevalence of obesity in this group. The study showed that the prevalence of overweight women is 64 per cent in urban areas and 36 per cent in rural areas. "Nowadays, most of the overweight women in urban cities find it difficult to conceive. This is because fat affect the production of hormone estrogen in women and therefore disturbs ovulation due to which conception becomes difficult. But I have commonly seen that the same women fall pregnant naturally the time they lose 5 to 6 kg," says Dr Asha Sharma, gynaecologist, Rockland Hospital.

Obese women who do conceive are more susceptible to complications during the pregnancy, and run a higher risk of miscarriage. This is because such women are usually at a risk of high blood pressure and gestational diabetes. "In a normal pregnancy a woman develops a mild form of insulin resistance. If a woman is obese, she is already insulin resistant, which induces gestational diabetes" says Dr H Pai, infertility expert, Fortis La Femme Centre for Women. Also, the incidence of Preeclampsia (elevated blood pressure in pregnancy) is about 4 to 5 times higher among pregnant obese women. Several complications due to obesity also lead to induced birth and caesarean. Stillbirth is also very common among obese women with the risk being 2 to 3 times higher than in normal weight women.

BABY AT RISK TOO

Researchers say overweight mothers not just put their own lives at stake, but that of their children too. Such babies are more susceptible to metabolic disorders and infections and require more care. And, in case of induced birth due to complications associated with high blood pressure and other factors, such women give birth to underweight babies, whose growth could be severely restricted. A study done at Newcastle University in Britain and recently published in the Journal of the American Medical Association compared women with a BMI 18.5 and 26 with obese women before pregnancy having a BMI of 29 or greater. The study found that obese women are more than twice as likely to give birth to children with spina bifida and more vulnerable to giving birth to babies with heart problems, cleft palate or cleft lip, abnormal rectum or anus development, and hydrocephaly, a condition in which excess spinal fluid builds up in the brain.

Another recent study by researchers from Duke University found that obesity in mothers causes cellular programming in utero that predisposes offspring to inflammation-related disorders such as Alzheimer's, Parkinson's, type 2 diabetes, stroke, heart disease. "Obesity in mother causes a major risk to foetus. But it's not the extra fat which harms the baby but the health conditions caused by obesity. For instance, hypothyroidism, which is common among obese women, can cause Intrauterine Growth Restriction (IUGR) in which the foetus is smaller than expected for the number of weeks of pregnancy. Similarly, if the mother transmits her diabetes to the foetus, it can have brain problems or spina bifida," explains Dr Sharma.

TOO FAT TO BE FERTILE

Four years ago there was a call for ban on fertility treatment for obese women in the UK. The British Fertility Society said free treatment should be limited to slim women, because obesity can reduce the success rate and lead to problems for both mother and baby. "The treatment of infertility using IVF techniques is more challenging in obese women. For instance, the pregnancy rates with IVF are lower in obese women than in women with normal weight as many obese women do not fully respond to the medications, and also because of the higher percentage of immature eggs in such women," says Pai.