Understanding Obesity in Pregnancy: What Women Need to Know
Dr Vicky Ho, Consultant Obstetrician & Gynaecologist at Sunway Medical Centre and President of the Malaysian Obstetric Medicine Society (MOMS), is working to change that. With a focus on high-risk pregnancies and pre-pregnancy care, she offers vital insight into the silent risks and actionable steps women can take to protect both their health and that of their baby.
Underaddressed, Not Underreported
Recent data show that more than 30% of Malaysian adults are classified as obese—a significant jump from previous years. While this figure is well-documented, the same cannot be said for the attention given to obesity in pregnancy.
Dr Ho clarifies that it's not a case of underreporting but of underaddressing. 'The awareness among reproductive-age women about how obesity impacts their fertility, pregnancy, and their child's future health is still low,' she says.
Weight Gain Myths and Harmful Advice
When asked whether the belief that weight gain is normal during pregnancy contributes to the under-addressing of obesity in pregnancy, Dr Vicky Ho confirmed that this misconception plays a significant role.
She explains that many women believe that the more weight a mother gains, the healthier the baby will be. Dr. Vicky stresses, 'A healthy baby does not equate to a big baby or a mother putting on too much weight.'
Dr Vicky recounts seeing patients whose mothers-in-law advised them to gain as much as 20 kilograms to ensure a large, healthy baby—but she warns that this approach is not only unnecessary, it can also be harmful.
'Many times, the weight gain in pregnancy is not equivalent to the baby's weight,' she explains. 'A mother can gain 20 kilos, but the baby may only weigh two kilos, and may even suffer from growth restrictions.'
She emphasises the importance of educating and empowering pregnant women about healthy weight gain, and of dispelling the persistent myth that more weight automatically leads to a healthier baby.
What Does Healthy Weight Gain Look Like?
So, what is considered a healthy amount of weight to gain during pregnancy? According to Dr. Vicky Ho, there's no one-size-fits-all answer. While antenatal cards offer general guidance, they aren't based on strict, universally accepted rules.
For mothers with a Body Mass Index (BMI) over 30, particularly those in the class three obesity category (BMI 40 and above)—a neutral weight gain is typically recommended. 'We don't want them to lose weight during pregnancy,' Dr Ho explains, 'but if they can try to maintain or just gain maybe less than five kilos, that would mean the mother has lost weight overall.'
In contrast, women with a healthy BMI should aim to gain around one kilogram per month in the first two trimesters and approximately 500 grams per week during the third trimester.
When Weight Becomes a Risk
If an expectant mother is overweight, her risk of developing health complications during pregnancy rises significantly. These issues can emerge as early as the first trimester and may include gestational diabetes, preeclampsia, thrombosis, sleep disorders, miscarriage, and mental health challenges.
'There's no magic weight where risk suddenly begins,' says Dr Ho. 'The risk increases the moment a woman is classified as obese at the start of pregnancy. Obese mothers are two to four times more likely to develop preeclampsia and up to ten times more likely to experience thrombosis.'
Impact on the Baby's Long-Term Health
The risks don't end at birth. Obesity during pregnancy can affect a child's future health, increasing their likelihood of becoming obese or developing metabolic disorders such as diabetes and high blood pressure.
'When mummy is obese during pregnancy, there is a higher chance that the child may be obese in the future as well,' says Dr Ho. 'If the mother experiences preeclampsia, the child may also be at higher risk of developing heart problems and hypertension later in life.'
Early Intervention and Support Matter
To tackle these risks, Dr Ho advocates for more emphasis on pre-pregnancy care. 'The best time to address obesity and other medical conditions is before pregnancy,' she says. 'We can diagnose issues like diabetes, high blood pressure, or even thalassemia early, and offer interventions before a woman conceives.'
For women who are already pregnant and obese, Dr Ho emphasises that support, not shame, is key. 'We're not here to scare you. We're here to help,' she says. 'If you're seeing the right doctor and following their guidance, you can still have a healthy pregnancy and a healthy baby.' Related
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