MDNews - Cleveland-Akron-Canton

HOSPITAL SPOTLIGHT MetroHealth Specialists Discuss Obesity, Pregnancy A and Related Issues By Robert Janek LMOST ONE-THIRDOFwomen in America are obese. For minor- ity women, such as African Americans and Hispanics, this number is even higher. And that's a com- plicated problem – not only for women who are or are planning to become pregnant, but also for their physicians. In fact, obesity in pregnant women is becoming the #1 concern of ob/gyns. "Obesity has issues for both the mom and the baby during pregnancy, including an increased risk of miscarriage, gestational diabetes, hypertension and preeclampsia for the mom and an increased risk of birth defects for the baby," says Patrick Catalano, MD. Dr. Catalano is director of the Center for Reproductive Health at MetroHealth Health System and director of the Clinical Research Unit of the CTSC Case Western Reserve University/MetroHealth. He's also a professor at Case Western Reserve University School of Medicine. A nationally renowned maternal/ fetal medicine specialist and researcher, Dr. Catalano was recently awarded the March of Dimes 2011 Agnes Higgins Award for outstanding achievement in the field of maternal-fetal nutrition. He and his colleague Bradley Stetzer, DO, have been involved in several multi-national studies related to obesity, pregnancy and gestational diabetes. In 2005, they participated in the multi- national study of hyperglycemia and adverse pregnancy outcome (HAPO) in which 23,000 women were enrolled. MetroHealth maternal-fetal medicine experts Drs. Patrick Catalano (right) and Bradley Stetzer (left) are working with patients to employ lifestyle intervention during pregnancy to decrease the problems associated with gestational diabetes. They are also collaborating with other physicians in the Endocrinology Department at MetroHealth to develop long-term prevention strategies for metabolic dysfunction in their patients before, during and after pregnancy. MetroHealth — one of four study sites, along with Brown, Northwestern and Kaiser in California — enrolled approxi- mately 900 women. The purpose was to determine what levels of glucose in pregnant mothers are associated with adverse pregnancy outcome. The data was published in The New England Journal of Medicine in May 2008. Perinatal risk factors examined in the HAPO study include increased risk of 18 | Cleveland-Akron-Canton MD NEWS ■ MDNEWS.COM ■ JULY-AUGUST 2012 a big baby, an increased risk of a baby with a lot of body fat, an increased risk of shoulder injury during birth (because of the baby's size) and an increased risk of cesarean section. "Because these babies tend to be fatter at the time of delivery, they are at risk for childhood obesity and metabolic dysfunc- tion," Dr. Stetzer explains. "So now the NIH has funded a study (the HAPO follow- up study) for the next three to four years,

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