Obese pregnant women may have an increased risk of losing their baby relatively late in pregnancy, and black women appear particularly at risk!Researchers found that obese women were 40 percent more likely than normal-weight and overweight women to have their pregnancy end in stillbirth -- defined as fetal death in the 20th week of pregnancy or later. African-American women were especially at risk. Compared with obese white women, their rate of stillbirth was 90 percent higher. Part of the reason for the obesity-stillbirth link may rest in the fact that obese women are more prone to diabetes and high blood pressure in pregnancy. Because black women have higher rates of these pregnancy complications than white women do, this may also help explain the racial gap. However, diabetes and high blood pressure are not the whole story. For example, obese women also have higher levels of lipids -- blood fats such as cholesterol. These fats suppress a substance called prostacyclin, which can narrow the blood vessels and promote blood clotting in vessels supplying the fetus.
Whatever the reason for the higher risk of stillbirth, the best way to reduce these odds is for obese women to shed weight before getting pregnant.
The findings are based on pregnancy outcomes of more than 1.5 million Missouri women who were pregnant between 1978 and 1997. Women who were classified as extremely obese had nearly double the risk of stillbirth as women who were normal-weight or overweight before becoming pregnant.
While weight loss before pregnancy may be the best way to prevent these stillbirths, this is clearly not possible for all women. Obesity itself has only recently been recognized as a risk factor for stillbirth and there are no standard recommendations on how doctors should address the problem.
