A study from Sri Lanka on 2,493 women with COVID-19 identified that pre-pregnancy overweight and obesity increases the risk of preterm delivery ( less than 37 weeks).
Data was collected from March 1, 2020, to October 31, 2021, by the Family Health Bureau, Ministry of Health, Colombo, Sri Lanka.
Pregnancy outcomes of mothers with COVID-19 infection
- Pre-pregnancy overweight and obesity increased the risk of preterm delivery compared to pregnant women with normal BMI by 46.7%.
- A premature birth rate of 11.9%
- Lower Segment Cesarean Section (LSCS) rate of 54.5%
- Low birth weight rate of 16.5%
- Newborns requiring intensive care – 8.3%
- The neonatal mortality rate (death within 28 days after birth) was 9 per 1000 live births.
The study Neonatal and Maternal Outcome of COVID-19 positive women in Sri Lanka: Secondary Analysis using National COVID-19 Positive Pregnant Women Surveillance is not yet peer-reviewed and is available at medRxiv.
The conclusions of this study indeed apply only to Sri Lanka, but it highlights that being overweight or obese results in worse COVID-19 outcomes. The SARS-CoV-2 has been detected in fatty tissues, and excess fat deposits result in a higher viral load and elicit an immune response.[3]
In another study, obesity also leads to lower production of inflammatory mediators in lung tissue to fight infection.[2]
Surprisingly, we found that Obese subjects had attenuated lung immune/inflammatory responses in SARS-CoV-2 infection, with decreased expression of interferon-alpha (IFN)α, interferon-gamma (IFNγ) and tumour necrosis factor alpha (TNF) response gene signatures in almost all lung epithelial and immune cell subsets, and lower expression of IFNG and TNF in specific lung immune cells.
Increased fat stores decrease the immune response in the lungs where it is needed to control the SARS-CoV-2 and allow the viruses to multiply in the fat cells, increasing the chance of prolonged and severe COVID-19.
Women planning to get pregnant should decrease their weight to lower the risk not only of COVID-19 complications but also pregnancy-induced diabetes and hypertension.
Obesity in women also leads to Polycystic Ovarian Syndrome PCOS, leading to hormonal imbalance and infertility. Diseases of the Female Urinary and Reproductive System Associated with Metabolic Syndrome.
Intermittent fasting can reverse infertility associated PCOS
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