Role of a comprehensive pregravid preparation program for obese women in the prevention of gestational complications

Objective. To determine the effectiveness of a comprehensive pregravid preparation program on the basis of studying the features of the course of pregnancy in obese women. Subjects and methods. Examinations were made in 118 reproductive-aged women who were permanent residents in the city of Perm. A study group consisted of 36 patients who underwent a comprehensive pregnancy preparation program (diet therapy, replenishment of macro- and micronutrients: vitamin D, folic acid, iodine, iron, and an anti-obesity drug combination of sibutramine + metformin). Comparison and control groups included women who were unprepared for pregnancy: the comparison group comprised 62 obese patients; the control group consisted of 20 non-obese women. Results. The study group showed an 8.3% weight loss. No reproductive losses were recorded in this group. It was established that threatened miscarriage was diagnosed in 10/32 (34.4%) patients who had received no pregravid preparation and in 7/36 (19.4%) women of the study group. During pregnancy, gestational diabetes mellitus developed in 16/32 (50%) women of the comparison group and in 4/36 (11.1%) women of the study group. Placental insufficiency was detected in 8/36 (22.2%) patients who had received pregravid preparation and in 20/32 (62.6%) who had not. Conclusion. The program proposed by the authors for pregravid preparation with the anti-obesity combination medication Reduxin Forte (especially for women with visceral abdominal obesity), vitamin D3, iodine, and folic acid and their recommendations for lifestyle modification significantly prevent gestational complications.

pregravid preparation, pregnancy, obesity, sibutramine, metformin, gestational diabetes mellitus, miscarriage, placental insufficiency