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Obese mums-to-be study sounds health alert

06.06.2006

Overweight and obese mums-to-be are putting their health and the health of their unborn infant at risk - as well as putting a strain on the health service!

That’s one of the main conclusions from a study into maternal obesity and pregnancy outcome conducted by researchers at the University of Teesside’s School of Health & Social Care. The findings of the scoping study will be published on the North East Public Health Observatory (NEPHO) web site on 6 June, 2006 – www.nepho.org.uk

An executive summary can found on the University of Teesside’s own web site at http://www.tees.ac.uk/schools/SOH/obesity_maternal.cfm

The research reviewed some of the clinical issues related to caring for obese pregnant mothers.

Professor Carolyn Summerbell, who heads up the University of Teesside’s Centre for Food, Physical Activity and Obesity Research, said: “We’re not trying to blame or stigmatize obese pregnant mothers and we would certainly not recommend that overweight mums-to-be go on crash diets. But our initial findings show reasons for concern with obese pregnant mothers, and there is a lack of weight management guidance and support readily available for them”

Lead researcher Nicola Heslehurst said the research team was alerted to the growing problem by anecdotal evidence from midwives and other staff in maternity units in the region who were getting extremely concerned about the apparent increase in the number of women who were obese at the start of their pregnancy.

“Doctors and midwives in the region have expressed concerns about the increase in complications that can arise when mums are obese. One of the problems is that sometimes you can’t see the ultrasound scan of the baby properly in obese pregnant women and this can lead to clinical problems as well as being upsetting for the parents who are not able to see a picture of their baby”.

The research indicated there were other implications for maternity services, including:

• Stronger equipment such as delivery beds to support heavy-weight mums
• Reduced patient choice and discouraging home births
• Referring patients to consultants rather than midwifery-led care
• Ruling out the use of birthing pools or alternative delivery methods
• An increase in caesarean sections
• Lifting and handling issues for staff in the maternity services

Professor John Wilkinson, Director of the North East Public Health Observatory (NEPHO) said: “We knew there was a problem with childhood obesity and with older adults but maternal obesity is something that has crept up on us “We had some evidence and were aware that heavier women were coming in to book a pregnancy, but we needed some hard evidence.”

He said an initial scoping exercise carried out by Nicola and her colleagues at the University of Teesside revealed that only six of the maternity units in the region’s 17 maternity hospitals under review kept systematic electronic data on obese mums-to-be.

“Until the late 1980s the height and weight of pregnant women was regularly monitored. But this became unfashionable in recent years as it was felt this caused unnecessary concern and worry to women who had gained a couple of extra pounds. But our study recommends that a routine system of monitoring the height and body weight of pregnant mothers is extended to all maternity units.

“This will allow comparisons between different social groups, ages and whether the mothers were having their first child and whether they were in employment. It will also enable us to judge the effectiveness of health promotion activities aimed at pregnant mothers.”

Dr Judith Rankin, Associate Director of the Regional Maternity Survey Office (RMSO) and a partner in the study, said: “This research will help to inform the NHS about the changes needed to the way service delivery is carried out and how the information is collected.”

Dr Rankin said research already carried out by the Confidential Enquiry into Maternal and Child Health indicates that a third of maternal deaths were in mothers who were obese.

“While this is clearly a serious issue, we don’t want to do anything that will encourage pregnant women who are obese to go on a crash diet during pregnancy. What they should do is try to eat a healthy diet during pregnancy and then lose weight after their child is born and before they have their next child,” she said.