The Impact of Obesity on Cardiac Function in Pregnancy

INTRODUCTION:

The prevalence of obesity is increasing to alarming rates worldwide. The impact of obesity on cardiovascular health is well documented, but much less is known about the impact of obesity in pregnancy on maternal cardiac function. The aim of the current study is to investigate how the cardiovascular system of morbidly obese women adapts to the circulatory changes associated with pregnancy.

BACKGROUND:

Overweight and obesity is a major threat to global health. In 2013, 36.9% of all men and 38% of all women worldwide were overweight or obese as defined by a BMI of ≥25 kg/m2 or of ≥30 kg/m2 respectively. According to a systematic analysis for the Global Burden of Disease Study 2013, South Africa ranks third in a list of the world's most obese nations behind the United States and Mexico. The prevalence of overweight (BMI ≥25kg/m2) and obesity (BMI ≥30kg/m2) combined in the age group above 20 years is estimated to be 38.8% for men and 69.3% for women in South Africa. In the age group below 20 years, it is 18.8% for boys and 26.3% for girls. 42% of women above the age of 20 years and 9.6% of girls below 20 years are considered obese.

The impact of obesity on the structure and the function of the heart is well documented. Obesity is strongly associated with risk factors for the development of atherosclerotic disease such as hypertension, hyperlipidaemia, and diabetes. In addition, there is evidence that obesity in itself can lead to structural and functional changes in the heart. The following changes are commonly encountered in obesity: