Maternal Fat and Gestational Complications.

One of the interesting terms I have explored in my Maternal Health Project is Subcutaneous Adipose Tissue(SAT) and Visceral Adipose Tissue(VAT). Adipose tissue is a loose connective tissue mostly composed of adipocytes and plays a major role in energy storage in lipids. Adipose fat also serves as an important cushion and insulates the body from heat and cold.

Subcutaneous Fat

• Subcutaneous fat is a type of fat that’s stored just beneath the skin. Our skin has 3 layers such as Epidermis, Dermis and Subcutaneous Fat, which is  the innermost layer skin.

• It's the type of fat which we can pinch between our fingers.

Visceral Fat

• Visceral body fat found deep within the abdominal cavity and wraps around many vital organs which cannot be seen.
  

• It's also called as "Active Fat" as it play an active role in how our body functions.
  

Some amount of fat is healthy and keeps the organs protected, provide our body with energy, help make important hormones, help with absorbing certain nutrients vitamins in our body. In pregnancy , the adipose tissue grows to fulfill the nutritional supply of the Fetus. But too much body fat at the start of pregnancy can lead to metabolic risk and developing gestational problems.

The body is measured by Anthropometric measurements including BMI, Waist Circumference, Hip Circumference and skin fold measurements. But these days Fat assessments are done through Ultrasound being a promising alternative and has got the ability to quantify subcutaneous fat tissue and visualize visceral fat depth.

Our study involved 272 expecting mothers who were included at different gestational ages.61 Patients lost follow up resulting in 211.

• At Inclusion, Maternal Ultrasound to determine the fetal growth, Placental position, fetal heartbeats, amniotic fluid level, and basic fetal anatomy were assessed in all cases.

• Blood Pressure readings were taken from both the arms, and the mean BP was calculated.

• Data regarding the frequency and quality of participant's nutritional food consumption was taken.

• Maternal Anthropometric data, Skinfold measurements were taken in consideration.

• Demographic and Laboratory data was included.

• The labor and delivery conditions, birth mode, newborn weight, and Apgar score were assessed and post delivery conditions were considered.
  

Our analysis shows that Mothers with Higher Fat mass are at higher risk of developing Preeclampsia,

Gestational Diabetes. We observed that women who experienced complications during pregnancy had greater levels of maternal visceral fat, especially gestational diabetes, which was linked to metabolic risk factors including insulin resistance and arterial blood pressure. Abdominal Obesity and visceral fat measures as the risk factor for increase in Blood Pressure. In Pregnant women ,Mean Arterial Pressure(MAP) is strongly influenced by increase in visceral fat.

Pregnancy with higher MAP levels are at greater risk of stillbirth and neonatal mortality.

Weight gain in pregnancy varies to each individual and depends on various factors including pre-pregnancy weight and BMI. Putting on too much or too little weight can lead to health problems for both mother or unborn baby. Too much weight gain in Pregnancy , may increase the risk of

• Preeclampsia

• Gestational diabetes

• Baby’s shoulder getting stuck during delivery (shoulder dystocia)

• Unplanned C-section

• Hard-to-shed postpartum pounds

Gaining less than the recommended weight may lead to Babies with a lower birth weight.

Summarizing the blog with these findings and recommendations.

• Slow and steady Weight gain in Pregnancy is best and It is important to focus on eating the right foods and staying active during pregnancy for smooth delivery and healthier newborn.

• A BMI in the range of 18.5-24.9 is recommended as ideal prepregnant BMI. Women in this range are found to have fewer complications in both delivery and fetal health. 

• Maternal abdominal Subcutaneous Fat Thickness (SCFT) and visceral Fat Thickness(VFT)measured by ultrasound at the fetal morphology scan is a better predictor of mode of delivery and other pregnancy outcomes than BMI.

• Maintaining fat levels at mid range to manage newborn and delivery outcomes.