News & Views National Enquiry into Maternal Obesity -
Implications for women, babies and the NHS The Centre for Maternal and Child Enquiries (CMACE) releases its report Maternal obesity in the UK: Findings from a national project after its three- year UK-wide national enquiry into Obesity in Pregnancy.
This major national study, which collected information from every maternity unit in the UK, has revealed for the first time the prevalence of severe maternal obesity (body mass index 35+) in the UK. The report also details the complications and consequences of obesity during pregnancy, and outlines the implications for the care of obese pregnant women.
This study found that around 5% of the UK maternity population were severely obese. In real terms, this equates to around 38,478 (1 in 20) pregnant women each year, and, with growing levels of obesity in the general population, this number is expected to increase.Wales was found to have the highest rate (6.5%, 1 in every 15 pregnant women) of severe maternal obesity in the UK. In England, the region with the highest rate was East of England (6.2%, 1 in every 16 pregnant women), while London had the lowest rates (3.5%, 1 in every 29 pregnant women).
The report highlighted that pregnancy
outcomes for severely obese women are poorer when compared to the general population. The study found that the stillbirth rate in women with a BMI 35+ (8.6 per 1000 singleton births) was twice as high as the overall national stillbirth rate (3.9/1000 singleton births), and that the risk of stillbirth increases with increasing obesity. Also, in women with a BMI 35+, stillbirths occurring during labour and birth were three times higher than the overall national rate in England, Wales and Northern Ireland.
The risks of obesity in pregnancy extend to the mother too. Pregnant women, and especially obese pregnant women, are more at risk of developing venous thromboembolism (VTE), which is a potentially fatal condition that involves a blood clot forming in a vein which may break away, travel through the circulatory system and obstruct a blood vessel. .
The CMACE report also revealed
that obese women have an increased risk of medical conditions both before and during pregnancy. Thirty-eight per cent of women in the study had at least one medical condition diagnosed prior to and/or during pregnancy. The most common conditions were gestational diabetes and pregnancy induced hypertension,which affect 8-9% of women with a BMI 35+; these conditions affect approximately 2-2.5% of women in the general maternity population. The
Bone Health Inquiry Calls for Evidence from Doctors, Scientists, The Food Industry, Patients
and Carers Sunlight, Diet and Supplements Under Scrutiny in Parliamentary Inquiry Parliamentarians to investigate the link between food and our bones
A wide-ranging parliamentary inquiry into the relationship between the food we eat and the health of our bones has been launched today. The enquiry is keen for anyone, from patients, carers and doctors, to scientists and the food industry, to give evidence by visiting
http://www.nos.org.uk/appog
presence of medical conditions increases the risk of complications for both the mother and baby, and increased surveillance and medical intervention are therefore required.
Only 55% of women with a BMI 35+
gave birth
naturally.The caesarean section rate for singleton babies was 37%, which is 1.5 times higher than the rate in the general maternity population. In addition, severely obese women were at least four times more likely to suffer from postpartum haemorrhage within 24 hours of birth than women in the general maternity population.
A set of ten key recommendations has been developed by CMACE in response to the findings in the report. The purpose of providing these recommendations is to highlight areas requiring better clinical practice.
Dr Tony Falconer, President of the
Royal College of Obstetricians and Gynaecologists (RCOG) said: “Pregnant women who are obese need to know about the associated risks for them and their baby and must be supported to lose weight before they embark on pregnancy. This will involve counselling and advice from a range of healthcare professionals including GPs, midwives, maternity support workers and nutritionists.”
When a woman finds out she is
pregnant, she tends to adopt positive behaviours to ensure that she is as healthy as she can possibly be and this includes sensible eating and lower alcohol consumption. However, we need to think about being more proactive by encouraging and enabling women to lead healthier lives before they fall pregnant and after giving birth so that they take a more long-term approach to being healthy”.
To view Maternal obesity in the UK:
Findings from a national project, please visit:
http://www.cmace.org.uk/Publications- Press-Releases/Report- Publications/
Obesity-in-Pregnancy.aspx
The All-Party Parliamentary Osteoporosis Group (APPOG) has issued a call for evidence as part of its inquiry into the role of nutrition in preventing osteoporosis and promoting good bone health. The group is examining the types of food choices that the public need to make to reduce their chances of developing the disease, which increases the risk of breaking a bone.
APPOG co-chair, Gordon
Marsden MP, said: “Previous studies have found that only a minority of people know that they can take steps to reduce their risk of osteoporosis.
We want to examine any factors that might be stopping people from eating healthily for their bones.We would like to know what can be done to promote good nutrition to help reverse the rising number of fractures which are occurring as a result of this devastating disease.We are keen to hear from anyone, from patients, carers and doctors, to scientists and the food industry.”
As part of the inquiry, the All-Party Group is also looking into the role that vitamin D plays in reducing the risk of osteoporosis. Fellow Co-Chair Baroness Cumberlege said: “We know that sunlight provides our best natural source of vitamin D. During the summer months, all adults should get about 10 minutes of sun exposure to their bare skin, once or twice a day, depending on skin type, without sunscreen and taking care not to burn.We are keen to find out the extent to which this message is getting through, and what the barriers might be to people getting enough sunlight to help look after their bones.We also intend to examine the role that food supplementation and fortification should have in preventing osteoporosis.”
APPOG is seeking written evidence from interested parties until Tuesday 4 January 2011. For more details on how to respond, please visit
http://www.nos.org.uk/appog
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From all at CM2 – publishers of CN Magazines Your voice in clinical, medical & health nutrition
6 | Complete Nutrition Vol.10 No.6 December/January 2010/11
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