Globally, obesity has now reached epidemic proportions. Although the prevalence is highest in developed 
countries, obesity has become an important health 
issue in many developing countries, often co-
existing with undernutrition.

Concomitant with the increased rates of obesity 
in the general population, rates during pregnancy 
have also escalated, and obesity is now a common 
high-risk obstetric condition. Information is limited 
on the prevalence of overweight and obesity during 

pregnancy in various countries. According to this 
book, the reported prevalence of maternal obesity 
in different cities and states of the USA ranged 
from10% to 26%.

Obesity is not only a health issue, but also has 
economic consequences. Total costs involve both 
direct costs related to medical expenditure on 
obesity-related diseases (including type 2 diabetes, 
cardiovascular diseases, several types of cancers 
and musculoskeletal disorders) as well as indirect 
costs related to absenteeism, reduced productivity, 
and disability. Studies from many countries have 
reported on the substantial and increased economic 
burden of obesity. Recognition of this problem has 
led to an explosion of research into causes and 
solutions, from the genetic to the population level 
and all points in between.

The pregnancy care of obese and overweight 
women provides a unique set of challenges. Excess 
weight affects fertility, pregnancy, delivery and the 
postpartum period. A specialised knowledge base 
and skill set are required to provide competent 
pre-pregnancy, obstetric and postnatal care to 
obese women. The aim of this book is to supply 
this knowledge to busy clinicians facing just such 
challenges. The reader will find collected in one 
location information covering every aspect of 
pregnancy in obese women beginning with the 
epidemiological scope of the problem and ending 
with postpartum care. This is the first edition of 
the book, edited by Deborah L.Conway of the 

احلمل يف املرأة البدينة
العالج السريري

املحرر: ديبورا كونواي

BOOK REVIEW

Pregnancy in the Obese Woman
Clinical Management

Editor: Deborah Conway
Publisher: Wiley-Blackwell, 1st Edition, 2011

ISBN: 978-1-4051-9648-2
Orders: www.wiley.com/wiley-blackwell

SQU Med J, November 2011, Vol. 11, Iss. 4, pp. 532-533, Epub. 25th Oct 11
Submitted - 20th Aug



Deborah Conway

Book Review | 533

Department of Obstetrics & Gynecology at the 
University of Texas School of Medicine,  

There is a growing body of evidence to suggest 
that obese women experience more psychological 
stressors and psychological disorders than normal 
weight women. In this book, composed of 14 
chapters, the second one describes the psychological 
aspects of obesity in women outside of and during 
pregnancy and offers pragmatic screening tools for 
use in clinical assessment during pregnancy.

In addition to the typical obstetrics topics like 
prenatal care, fetal surveillance and delivery, in 
chapter 4 the book addresses bariatric surgery 
(vertical banded gastroplasty and Roux-en-Y gastric 
bypass). This surgery is recommended for women 
with a body mass index of 40 kg/m2 or over who 
have failed at conventional weight loss attempts, 
have been properly educated and are motivated for 
surgery. Chapter 5 deals with post-bariatric surgery 
pregnancy-related complications like hypertensive 
disorders and gestational diabetes. Caesarean 
sections are more prevalent in women who have 
undergone bariatric surgery. However, there is no 
difference between them and the general population 
in intra-partum complications like placental 
abruption, labour dystocia and meconium-
stained amniotic fluid. Chapter 5 also covers fetal 
malformation and birth weight problems like small 
for gestational age neonates and macrosomia.

The reader will find covered in this book the 
special considerations needed in prenatal care for 
obese women and the limitations of ultrasound in 
anomaly detection as well the difficulty of invasive 
testing. It also covers late pregnancy and intra-
partum care, especially breech presentation and 
trial of labour in obese women.

Other chapters address the adverse consequen-
ces of maternal obesity during pregnancy, as well 
the adverse effects on child health outcomes later in 
life such as: child, adolescent and adult obesity; high 

blood pressure; metabolic syndrome, and cardio-
metabolic complications. Chapter 13 focuses on 
the preparation of the obese pregnant women for 
surgery and anaesthetic considerations as well 
antibiotics and pre-operative and post-operative 
care.

The last chapter, the most interesting one 
in my opinion, focuses on how obesity affects 
breastfeeding and contraception. The various 
contraception methods are described in detail. 
Since obesity increases the failure rates of several 
methods, the book proposes that there is a need 
for in depth evaluation, which should take into 
consideration the woman’s personal, social, family 
and medical history.

This book is unique on several scores. It focuses 
on a problem that has now reached epidemic 
proportions and uses evidence-based medicine 
to cover many aspects of obesity in pregnancy in 
one volume. It is an excellent source of up-to-date 
information and, in addition, it is very easy to read 
and digest. Overall, this book is therefore a useful 
resource for medical students, obstetric residents, 
and general and high-risk obstetricians. 

I will definitely use this book for reference and I 
highly recommend it to others.

Rahma Al-Haddabi 
Department of Obstetrics & Gynaecology
Sultan Qaboos University Hospital, Muscat, Oman
Email: rahmahamed@hotmail.com