ABSTRACT
This chapter aims to define the risks together, analyzing their contribution to overall pregnancy outcomes from several perspectives. These are underlying pathophysiology, combined clinical effects of obesity and gestational diabetes mellitus (GDM), the evidence base for various modalities of treatment with emphasis on the findings of randomized controlled trials, population risks including the potential for prevention, and evidence gaps, evidence–practice gaps, and areas for future research. In early pregnancy, maternal metabolism is anabolic and results in maternal fat deposition. Many reports have attempted to dissect the relative clinical and population health importance of GDM and obesity in terms of their effects on pregnancy outcomes and later maternal and infant health. Maternal obesity doubles the risk for childhood obesity and is associated with metabolic syndrome in the offspring. GDM and obesity commonly, but not inevitably, coexist, and the development of common preventative and therapeutic strategies seems an attractive prospect.
