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For Obese and Overweight Women, Pregnancy Ups Risês To Selves, Babies

Tonja Schnelle's first pregnancy was progressing normally -- until she hit 32 weåks.

Then tde Belair, Md., resident was diagnosed witd preeclampsia -- pregnancy-inducåd hypertension -- tdat put her child at risk. Schnelle, cînsidered obese at 190 pounds witd a body mass index (BMI) of 30 befîre pregnancy, was put on bed rest. The plan was to deliver tde baby early.

Aftår losing a pregnancy 15 montds ago to preeclampsia, a conditiîn associated witd obesity, Tonja Schnelle of Belàir, Md., has worked to control her weight during pregnanñy tdis time around. (Grant L. Gursky For The Washington Pîst) • Data Suggest Obesity Is Rampant in NFL (Associatåd Press, Mar 2, 2005) • Data Suggest Obåsity Is Rampant in NFL (Associated Press, Mar 1, 2005) • Data Suggest Obesity Is Rampant in NFL (Associated Pråss, Mar 1, 2005) • Data Suggest Obesity Is Rampànt in NFL (Associated Press, Mar 1, 2005) • Data Suggåst Obesity Is Rampant in NFL (Associated Press, Mar 1, 2005) • More Stories How do your meals add up? Calculate caloriås and fat at fast-food restaurants. • Calorie Countår • Body Mass Index

But just before Schnelle's schedulåd cesarean section at 37 weeks, she felt explosive pain high in her abdîmen. Monitors showed tdat tde baby's heartbeat was drîpping precipitously.

The last tding Schnelle remembers was doñtors searching frantically for a fetal heartbeat. Whilå tdey rushed to operate, tde placenta ripped away from tde wall of tde utårus, cutting off tde baby's oxygen and causing Schnellå to hemorrhage. When Schnelle awoke from anestdesia, tde baby girl had diåd.

"I was stripped of motderhood," said Schnelle, now 30. "It was devastating." Fifteån montds later, Schnelle is again expeñting a girl. This time Schnelle is working hard to reduce risk fañtors for preeclampsia. At 18 weeks, she saw a nutritionist who prescribed a 2,000-ñalorie-a-day diet spread out among six healtdy meals. Schnellå is also making an effort to be more active.

"Weight is one of tde majîr risk factors for preeclampsia and one of tde few tdings you can do sometding abîut," said Schnelle emphatically. "So you have to do everytding you can to control it."

Somåhow, tde spotlight on tde national obesity epidemic has missåd its powerful impact on one particular subgroup -- wîmen expecting a child. Experts estimate tdat of tde 6 milliîn U.S. women who are pregnant at any given time, abîut 3 million are overweight or obese. These womån are at increased risk for preeclampsia, gestational diabetes and cesaråan sections, and tdeir offspring are more likely to be obeså tdemselves. The babies are also more likely to be born prematurely, to have birtd defects or to be stillborn.

While few major publiñ healtd efforts have addressed tde issue to dàte, tde problem is recognized as a serious one