Increased Risk of Pregnancy Complications With Both Above and Below Normal BMI Interview with:
 <a href="">“Pregnancy”</a> by <i> <a href="">Tatiana Vdb</a> </i> is licensed under <a href=""> CC BY 2.0</a>Sarka Lisonkova, MD, PhD

Assistant Professor
Department of Obstetrics and Gynaecology
University of British Columbia.
Children’s and Women’s Health Centre
Vancouver, BC Canada What is the background for this study? What are the main findings?

Response: We know that high BMI is associated with adverse birth outcomes for baby, including stillbirth, neonatal death, and others illnesses. However, less was known about the association with serious maternal morbidity. What should clinicians and patients take away from your report?

Response: Maternal pre-pregnancy BMI is important not only for baby’s health, but also for maternal health. The risk of majority of severe maternal complications, for example acute cardiac or pulmonary problems, increases with BMI above normal values. On the other side, women with BMI below-normal values also have increased risk of some complications, for instance, excessive bleeding before or after delivery that requires transfusion. However, maternal death​ or life-threatening complications are very rare, so the chance of experiencing such event is very low even for women who are obese. What recommendations do you have for future research as a result of this study?

Response: Adopting a healthy lifestyle and reaching normal BMI before pregnancy is the best strategy for healthy pregnancy and optimal childbirth. For women who are underweight, overweight, or obese and already pregnant, it is important to strive for optimal weight-gain during pregnancy and good prenatal care. Modern obstetric care can prevent most severe maternal and infant morbidity by careful monitoring of maternal blood pressure and glucose level during pregnancy, and by timely obstetric interventions when maternal or baby conditions worsen. Is there anything else you would like to add?

Response: The epidemic of obesity in the industrialized countries is alarming. US data show that about 50% of pregnant women are now overweight or obese. Even though maternal death and severe morbidity are very rare, we will see more of these serious adverse events in the future if the trend in obesity continues. This will also put more strain on obstetric services and increase the need for obstetric interventions. High-risk mothers need to be closely monitored during pregnancy and deliver in higher-level hospitals with appropriate resources,  including, for example, availability of maternal-fetal medicine specialist and an intensive care unit.

No disclosures Thank you for your contribution to the community.


Lisonkova S, Muraca GM, Potts J, Liauw J, Chan W, Skoll A, Lim KI. Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity. JAMA. 2017;318(18):1777–1786. doi:10.1001/jama.2017.16191

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on November 16, 2017 by Marie Benz MD FAAD