ABSTRACT
Obesity presents one of the greatest cross-disciplinary challenges to practicing clinicians worldwide, and in many ways defines the changing face of modern obstetrics and gynecology. Data from the Pregnancy Risk Assessment Monitoring System show a pre-pregnancy incidence of obesity in the United States of 20%. The first evidence that genetics is important in common nonsyndromic obesity came from a study that reported that the observed familial aggregation for obesity was due to genetic factors rather than environmental influences. Both obesity and gestational diabetes are associated with insulin resistance; however, each condition has an additive and independent effect on maternal and neonatal outcomes. Maternal obesity is associated with difficulty in the initiation and maintenance of breastfeeding. So, focusing on maternal obesity and universal hyperglycemia in pregnancy screening during pregnancy provides a unique opportunity to integrate services that would not only lower maternal and perinatal morbidity and mortality but would also address intergenerational prevention of obesity, diabetes, hypertension, and cardiovascular disease.
