Being overweight significantly increases the risk of complications during pregnancy and childbirth. This issue affects both women born in Sweden and those who have immigrated here, a topic that has not been extensively studied previously. Researchers suggest that if interventions aimed at achieving a healthy weight are implemented, they could help prevent complications for all these women. The findings of this research, conducted by experts from Linköping University and Karolinska Institutet, were published in The Lancet Public Health.
In Sweden and other wealthy nations, there exist disparities in pregnant women’s health. Specifically, women from migrant backgrounds face a higher prevalence of severe complications during pregnancy compared to their Swedish-born counterparts. This risk is more pronounced among women from specific regions. Although the reasons for this discrepancy remain unclear, various health-related factors might contribute, one of which is body weight. Many migrant women from certain areas tend to experience underweight, overweight, or obesity (defined by a BMI of 30 or more) when they become pregnant.
“We know that overweight and obesity lead to numerous complications during pregnancy and childbirth for women born in Sweden. As a result, we aimed to explore whether the discrepancies in complications among women from different countries could partly be attributed to variations in body weight. Understanding these health disparities can help us identify solutions to address them,” explains Pontus Henriksson, a senior associate professor at the Department of Health, Medicine and Caring Sciences at Linköping University and the study leader.
This study introduces a new insight by estimating how many complications, such as gestational diabetes, could be prevented if all women maintained a normal weight before pregnancy.
“Our findings suggest that nearly half of all gestational diabetes cases could potentially be prevented, benefiting both Swedish-born women and those born abroad,” states Maryam Shirvanifar, a PhD student at Linköping University and the lead author of the research.
The researchers believe that initiatives promoting healthy weight are beneficial for all women, regardless of their country of origin.
“Maintaining a healthy weight is universally advantageous. The earlier this is addressed, the better, as it becomes increasingly difficult to manage obesity once it is established,” adds Pontus Henriksson.
The study highlights a complex scenario. The impact of body weight varies across different complications. For instance, excess body weight plays a more significant role in gestational diabetes compared to other issues.
But what about women who are underweight in early pregnancy? Surprisingly, the researchers found that underweight does not appear to significantly contribute to the complications evaluated.
The research followed nearly two million pregnancies—essentially all births in Sweden between 2000 and 2020. The researchers examined eight complications affecting either the mother or baby during pregnancy and childbirth. By utilizing data from multiple national registers, they assessed how a woman’s BMI at her first antenatal visit related to complications based on her place of birth.
In their analysis, the researchers considered several variables, including socio-economic status. However, some impactful factors—such as the quality of healthcare treatment, communication challenges, stress related to migration, and variations in health-promoting behaviors—could not be addressed in this study due to the reliance on register data. Consequently, more research is needed to explore additional factors influencing health during pregnancy across diverse groups.
This study received funding from the Swedish Research Council and involved collaboration among researchers at Linköping University and Karolinska Institutet, including Viktor Ahlqvist and Cecilia Magnusson.
In their research, the team focused on eight specific complications concerning the mother and baby:
— severe maternal complications that could lead to death
— preeclampsia
— gestational diabetes
— infant mortality within the first year
— preterm birth (before 37 weeks of gestation) and extremely preterm birth (before 28 weeks of gestation)
— low Apgar score (a measure of a newborn’s health)
— large baby (relative to gestational age)
— small baby (relative to gestational age)
