More on foetal nutrition...

We encourage women to improve their health as much as they can before becoming pregnant. A small weight reduction improves fertility and I see a lot of women who achieved a pregnancy unexpectedly having made improvements to their diet and lost some weight.

The whole arena of weight and obesity is fraught with difficulty in Women's Health. Obesity reduces fertility and then increases the risk of pre-eclampsia and gestational diabetes in pregnancy. There is also an increased incidence of twin pregnancy in obese women, and a twin pregnancy is a higher risk pregnancy for both mother and babies. Overweight and obese women often have bigger babies who then have associated delivery problems such as shoulder dystocia and an increased likelihood of an instrumental delivery or cesarian section.

The maternal metabolomics of obese women appear to have even further consequences as reported at a conference on fertility in Denmark earlier in the summer. Daughters of obese mothers are more likely to have reproductive and menstrual problems as teenagers and adults.

I still belive we have to focus on prevention, and I strongly belive that the professionals working in Women's Health are in a unique position to help. Healthier mothers mean healthier babies. Positive messages at a receptive time such as pregnancy can be implemented far into the future.

But we also need to be researching and recording the implications of our interventions and sharing information as widely as possible.