Pre-pregnancy obesity: Gynaecologist explains risks of infertility, gestational diabetes and c-section

Pre-pregnancy obesity can raise risks of infertility, gestational diabetes, and C-section. A gynaecologist explains why maintaining a healthy weight before conception is important.

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Written By: Muskan Gupta | Updated : April 24, 2026 1:13 PM IST

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Medically Verified By: Dr. Thejaswini J.

Pre-pregnancy obesity increases the maternal risk profiles. If the patient is obese even before conceiving, she is going to gain weight even during pregnancy, and it will increase her risk of gestational diabetes mellitus, and it will also increase her risk of pregnancy induced hypertension. Besides, it can put her at risk of infertility. She might not even be able to get pregnant smoothly, and might have to take treatments to get pregnant.

Even when she gets pregnant, there is an increased risk of diabetes and hypertension, and also the obese women have an increased risk of going in for a cesarean section and a lesser chance of normal delivery.

BMI vs metabolic markers in pregnancy risk assessment

According to Dr Thejaswini J, Consultant Obstetrician and Gynaecologist, Motherhood Hospitals, Electronic City, Bengaluru, "BMI is not the only marker or predictor of complication. Metabolic profiles are also very important because we often see very thin women having pre-diabetes. Their sugar levels are very important. Some women are thin, but they have lot of visceral fat which pushes them into the risk of diabetes during pregnancy."

Anaesthesia challenges in obese pregnant women

Obese women even face higher anaesthesia risks during delivery because there could be difficult intubation and even spinal anaesthesia might be difficult in obese people. Furthermore, even epidural analgesia is also very difficult, as it might not act very well in obese women. In case if it is general anaesthesia, the recovery from anaesthesia will also be difficult.

Impact of sedentary lifestyle and diet on maternal obesity

The new onset of obesity can be blamed on urban lifestyle and sedentary nature of the work which, the urban people have. In urban lifestyle, they don't really have to physically exert rather they have a lot of mental exertion. Besides they have these graveyard shifts, which put their endocrine system to a toss. Usually they have to start working at seven o'clock in the evening and then go on working till early morning three to four o'clock, which will definitely cause a havoc with their endocrine system and make them infertile and obese.

With very less time available for people to have home-cooked meals or to cook at home, consuming a lot of fast foods, and some people even pride themselves telling that they are a foodie. These things are definitely increasing the incidence of maternal obesity.

Some women have home-cooked meals, but there is something called as overfeeding and malnutrition. There is no protein, and no fibre in their diet, rather a lot of carbohydrates. Even though they are not eating out and only having home-cooked meals there is not right amount of proteins and fibres in the food.

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