The Royal College of Midwives is calling for urgent action to deal with the growing problem of obesity in pregnancy, following the publication of a study by the National Perinatal Epidemiology Unit at the University of Oxford, into the scale of the problem in the UK.
The research found that of the 764,387 women who gave birth between September 2007 and August 2008, some 665 had a BMI of 50 or more. This is a prevalence of almost one in every 1,100 maternities. Dr Marian Knight, who led the study, said that the researchers were “astonished” by the high number of women who were in this super obese category, which was twice the figure expected. They also found that extremely obese women with a body mass index (BMI) of 50 or higher experienced greatly increased risks of complications during pregnancy and that basic equipment for their care was not universally available. The women studied were nearly nine times likelier than average-sized expectant mothers to develop diabetes during pregnancy, over five times likelier to get pre-eclampsia and four times likelier to need intensive care. In addition, half of the 665 had a caesarean – twice the national average. Mervi Jokinen, practice and standards development advisor at the Royal College of Midwives, said: “There is a real need to address the issue of obesity, and as this research shows this is particularly important for pregnant women. The growing volume of evidence shows that the health of the mother with extreme obesity is further compromised by the pregnancy and also has an impact on the health of her unborn baby. Poorer health for mother and child can also lead to greater future strain on health services. This is something that also has major effects before and beyond pregnancy and it needs to be addressed as a matter of urgency. “As a result of the increase in obesity among pregnant women midwives are dealing with more complex births – on top of the continuing baby boom. These women need to see a midwife as early as possible in their pregnancy, and they need more time to spend with these women to help and advise them as well as involving the wider health care team. Trusts should be making sure that they have the resources in place to do this. “There are many good examples of midwives and maternity services successfully tackling obesity in pregnancy, and Trusts should be learning from each other to adopt and use these examples. “There is also a much broader public health message needed about obesity – not just in pregnancy – that being seriously overweight can have a serious and negative effect on peoples’ health. The growing levels of obesity suggest that we have not yet got the message.”
