Body Mass Index Can Affect Pregnancy Chances I TCM Puchong

Introduction

When planning for pregnancy, understanding the impact of Body Mass Index (BMI) on fertility and pregnancy outcomes is crucial. As a TCM Centre in Puchong, Golden Gate fertility centre, we emphasize the importance of maintaining a healthy BMI to optimize your chances of conceiving and ensuring a healthy pregnancy. This comprehensive guide explores how different BMI categories affect fertility and pregnancy, covering the risks associated with being underweight, overweight, or obese, and the effects on male fertility, such as sperm quality.

The Relationship between Body Mass Index (BMI) with Pregnancy

BMI, a measure of body fat based on height and weight, categorizes individuals as underweight, normal weight, overweight, or obese. For pregnancy, a BMI outside the normal range (18.5-24.9) can pose risks. Specifically, a BMI over 25 is considered overweight, have high-risk for pregnancy complications, while a BMI over 30, classified as obese, significantly increases these risks. Conversely, athlete or model with a BMI below 18.5 is categorized as underweight and can also negatively impact fertility and pregnancy, as well as have higher risk during delivery.

High BMI Effects on Pregnancy

Gestational Diabetes Mellitus (GDM) and Macrosomia

Women with a high BMI are at an increased risk of developing gestational diabetes, a condition characterized by high blood sugar during pregnancy. This not only complicates the pregnancy but also increases the risk of developing type 2 diabetes later in life for both the mother and the child. Pregnancy complication such as macrosomia, defined as newborns exceeding 4kg at full term, is a well-known complication of GDM. It can lead to complication like shoulder dystocia during delivery. While a mother’s size and genetics can influence baby weight, doctors use ultrasounds to monitor suspected cases. Gestational diabetes mellitus needs additional test to diagnosed and confirmed. Early detection allows for adjustments to the delivery plan, like labour induction or a scheduled cesarean section, ensuring a safe and smooth birth experience for both mother and baby.

Stillbirth

Stillbirth is another complication associated with high maternal BMI; it is a heartbreaking experience that can occur during pregnancy. Stillbirth occurs when a baby dies after 20 weeks of pregnancy, it is higher risk in women who are overweight or obese. Often due to complications like placental abruption (placenta detaching from the uterine wall), umbilical cord problems, or birth defects. In some cases, the cause of stillbirth remains unknown.

Pregnancy-Induced Hypertension (PIH)

High BMI is strongly associated with an increased risk of developing high blood pressure during pregnancy, known as pregnancy-induced hypertension. This condition can lead to more severe complications such as preeclampsia, which is dangerous for both the mother and the baby.

Congenital anomalies

Congenital anomalies are birth defects that arise during fetal development, affecting a baby’s structure and function. These can range from minor physical variations to more serious malformations of organs, limbs, or the brain. Congenital anomalies that are associated with high BMI or obese mother are such as spina bifida, omphalocele, heart defects and multiple anomalies. Early detection through prenatal testing can help families prepare and access necessary medical care for their baby.

Spontaneous abortion

Risk of spontaneous abortion, or miscarriage is also higher in obese mother in early pregnancy for both spontaneous conception and IVF pregnancy. This is cause by enzymes and hormones produce by adipose tissue.

Effects on Delivery

Overweight and obese women are more likely to have longer labour and may require interventions such as induction of labour or caesarean delivery. They also have a higher risk of complications such as postpartum haemorrhage, which is bleeding more than 500ml, wound infection, postpartum endometritis, postpartum thrombophlebitis, or anesthesia complications.

Underweight and Fertility

Being underweight can be just as problematic as being overweight when it comes to fertility and pregnancy. Women who are underweight often have irregular menstrual cycles or may stop ovulating at all, reducing their chances of conceiving, this commonly seen in model and professional athlete. Moreover, underweight women are at a higher risk of preterm birth and

having babies with low birth weight compared to their counterpart’s babies of same gestational age.

BMI and Sperm Quality

Men’s fertility is not immune to the effects of BMI. Overweight and obese men often have lower sperm counts and poorer sperm quality compared to men with a normal BMI. The excess fat can increase the temperature around the testes, negatively affecting sperm production and function.

Management of BMI for Pregnancy

Women with overweight or obesity conditions tend to take longer time to conceive, have a decreased fertility rate, and higher miscarriage rate than those with normal weight. Meanwhile, Obesity also increases the risk of subfertility in men, mainly due to the disruption of hypothalamus-pituitary-gonadal (HPG) axis, increased testicular temperature, impairment of physical and morphology of sperm, etc. Lifestyle interventions are great way to tackle the problem associated with higher BMI and fertility (Amiri and Ramezani 2020).

A modest weight reduction of 5% and achieving a lower BMI, coupled with maintaining normal triglyceride levels, have proven to be significant and independent factors in boosting pregnancy rates among obese women. This not only helps in managing weight but also improves overall metabolic health, thereby increasing the chances of conception for obese women (Bond et al. 2020).

Obstetric Complication in Obese Pregnant Women