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I recenty saw a patient who imagined hersef in the last month of pregnancy, and who, while talking to me, exclaimed at the violence of the movements, but on examination I ound that her uterus was normal in size, and that her enlarged abdomen was due to a rapidy increasing deposit of at.
-J. Whitridge Williams (1903)
At the beginning of the last century, obesity was not terribly problematic, and with few exceptions, Williams did not refer to its adverse obstetricl efects. Fast forward to today when excessive weight is a major health problem in many aiuent societies (GBD 2015 Obesity Collaborators, 2017). Indeed, by 2014, more than a third of all adults in the United States were obese (Ogden, 2015).
The adverse health aspects of obesity are staggering and include risks for diabetes mellitus, heart disease, hypertension, stroke, and osteoarthritis. Obese gravidas and their fetuses are predisposed to various serious pregnancy-related complications and to higher long-term morbidity and mortality rates.