Obesity in pregnancy: why we must be concerned about maternal nutrition again

The causes of the nutritional transition in our country can be accounted for by the reduction in the number of malnourished people, on the one hand, and the explosive increase in the proportion of overweight and obesity in all age groups, on the other. It comes as no surprise then that more than half of Chilean pregnant women are overweight and obese at their first prenatal visit and thus have an almost inevitable tendency to gain excess gestational weight. The purpose of this article is to review the adverse effects of maternal overweight on women and their offspring, and the potential benefits of nutritional interventions in this area. Multiple population and experimental studies have demonstrated a two to three times greater likelihood of developing maternal and perinatal complications in pregnant women with overweight and obesity compared to women with normal nutritional status. Since the gestational period is critical for the development of an individual, metabolic changes in nutrients, hormones and inflammatory mediators could explain many of the adverse outcomes described in the medium and long term in children of mothers with excess weight during pregnancy. No significant effects on birth weight have been seen after employing various interventional strategies. However, both dietary interventions and those involving controlled physical activity during pregnancy have been found to limit total gestational weight gain. In consequence, it appears to be feasible to further evaluate potentially clinically significant differences, both at the maternal-fetal metabolic injury level during pregnancy, as well as later on in life in mothers and their offspring.