title: Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines.
abstract: OBJECTIVE
  This study aims to compare how national guidelines approach the management of obesity in reproductive age women.
  
  
  METHODS
  We conducted a search for national guidelines in the English language on the topic of obesity surrounding the time of a pregnancy. We identified six primary source documents and several secondary source documents from five countries. Each document was then reviewed to identify: (1) statements acknowledging increased health risks related to obesity and reproductive outcomes, (2) recommendations for the management of obesity before, during, or after pregnancy.
  
  
  RESULTS
  All guidelines cited an increased risk for miscarriage, birth defects, gestational diabetes, hypertension, fetal growth abnormalities, cesarean sections, difficulty with anesthesia, postpartum hemorrhage, and obesity in offspring. Counseling on the risks of obesity and weight loss before pregnancy were universal recommendations. There were substantial differences in the recommendations pertaining to gestational weight gain goals, nutrient and vitamin supplements, screening for gestational diabetes, and thromboprophylaxis among the guidelines.
  
  
  CONCLUSIONS
  Stronger evidence from randomized trials is needed to devise consistent recommendations for obese reproductive age women. This research may also assist clinicians in overcoming one of the many obstacles they encounter when providing care to obese women.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Chicago, Illinois.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kominiarek
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000628:therapy*; D011181:Postnatal Care; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000628:therapy*; D011295:Prenatal Care; D015430:Weight Gain