Obesity in pregnant women: a primary care perspective on pre-conception counselling and the role of supplements

Around one-fifth of pregnant women in the UK are obese (body mass index [BMI] ≥30).1 This is a significant public health concern as obesity in pregnancy is associated with increased risks to both mother and baby. Obese pregnant women have a higher risk of pre-eclampsia, gestational diabetes, venous thromboembolism (VTE), caesarean section, and death compared with their counterparts with a normal BMI.1,2 The babies of obese mothers are also more likely to suffer complications. Congenital abnormalities, macrosomia, diabetes in later life, stillbirth, and neonatal death are all more common in the offspring of obese mothers.1 This article will discuss how preconception counselling can reduce these risks and review the role of supplements. The Royal College of Obstetricians and Gynaecologists recommends that all women with a BMI ≥30 should receive preconception counselling and that ‘primary care services should ensure that all women of reproductive age have the opportunity to optimise their weight before pregnancy’ .1 The causes of obesity are multiple and include a complex interplay between the psychological and situational. Maternal obesity has been shown to be associated with parity, ethnicity, and deprivation.3 It is unlikely that GPs will be able to address the root cause of obesity in a single consultation. However, intervention pre-conceptually provides an opportunity to affect …