A recent study published in the Canadian Medical Association Journal (CMAJ) has highlighted a concerning correlation between obesity and an increased risk of stillbirth, particularly as pregnancies approach full term.

Lead author Dr Naila Ramji, an assistant professor at Dalhousie University and high-risk pregnancy specialist in Fredericton, New Brunswick, emphasised that pregnant individuals with obesity face a higher risk of stillbirth, with potential implications for their delivery timeline.

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The study in Canada analysed data from the Better Outcomes Registry and Network on over 680,000 singleton births between 2012 and 2018 in Ontario, of which approximately 0.4% resulted in stillbirths.

Dr Ramji and her team, including senior author Dr Laura Gaudet from Queen's University and coauthors from The Ottawa Hospital, focused on understanding the relationship between obesity and stillbirth risk across different gestational ages and obesity classes.

Their findings revealed a significant increase in stillbirth risk as gestational age advanced, with individuals in the obesity classes II and III facing 2 to 2.5 times the risk of those with a normal BMI.

Moreover, the risk doubled for individuals with class I obesity at 39 weeks gestation compared to those with a normal BMI.

Dr Ramji expressed concern over potential biases within the medical community, highlighting that the risk thresholds associated with obesity were higher than those for other medical conditions known to increase stillbirth risk.

The study also noted a higher likelihood of stillbirth occurring before delivery among individuals with class I and II obesity.

In light of these findings, the authors advocate for improved care and heightened surveillance for pregnant individuals with obesity, particularly as they approach full term. They suggest that timely referral and increased monitoring closer to term, coupled with potential earlier delivery for those with additional risk factors, could help mitigate the heightened risk of stillbirth.

A registered dietitian, Dr Cahill underscored the importance of providing respectful prenatal care free from weight stigma and discrimination.

She emphasised the need for healthcare providers to recognize the unique challenges faced by pregnant individuals with obesity and work towards ensuring positive maternal and fetal outcomes without reinforcing weight biases or stereotypes.