Preconception and pregnancy care in overweight or obese woman

Overweight and obesity are associated with multiple maternal and fetal complications, including gestational diabetes mellitus, hypertensive disorders of pregnancy, macrosomia (infant weighing more than 4,000 g), and cesarean delivery. The preconception period is a critical time frame to address overweight and obesity in reproductive-aged women. Preconception care should include education about the effect of obesity on pregnancy outcomes, long-term health of the offspring, clinical evaluation for comorbid conditions, assessment of the patient's readiness for change, and guidance on safe and effective interventions to achieve a healthy weight prior to conception. Current gaps in our knowledge include the identification of the most effective lifestyle strategies to promote a healthy weight prior to pregnancy and the development of policies to improve the dissemination of patient-centered preconception care.