The costs to the National Health Service (NHS) for overweight and obesity-related conditions are projected to reach £50 billion per year by 2050 (Foresight 2012).
The increase in obesity in the UK population has significant implications for women of childbearing age and has been described as the biggest challenge for maternity services today (Centre
for Maternal and Child Enquiries (CMACE) 2010).
Ailsa McGiveron, lead midwife for Bumps and Beyond Antenatal Weight Management Service, Lincolnshire Community Health Services considers the psychosocial aspects of obesity in pregnancy in her article which appears in the June issue of MIDIRS Midwifery Digest. A short extract follows:
‘Pregnancy is socially acceptable, but being fat is not’: considering psychosocial aspects of obesity in pregnancy’ by Ailsa McGiveron
Historically, the relationship between weight gain and pregnancy focused upon inadequate maternal weight gain (Siega-Riz et al 2004). The consequences of inadequate weight gain for fetal growth were traditionally thought to be such that pregnant women were advised to ‘eat for two’ and avoid slimming.
However, more recently, the impact of excessive weight gain and obesity in pregnancy has shifted the focus. Obesity is a serious public health concern. Not only does it burden our society with increased health care costs, pose risks for disease, disability and death, it also presents many social, emotional and aesthetic concerns. The abundance of energy dense foods, motorised transport and sedentary lifestyles are causing the people of Britain to become heavier simply by living in the Britain of today. Modern living ensures that every generation is heavier than the last — a trend known as ‘passive obesity’ (Foresight 2012).
The costs to the National Health Service (NHS) for overweight and obesity-related conditions are projected to reach £50 billion per year by 2050 (Foresight 2012). The increase in obesity in the UK population has significant implications for women of childbearing age and has been described as the biggest challenge for maternity services today (Centre for Maternal and Child Enquiries(CMACE) 2010). Pregnancy contributes towards the development of obesity through excessive weight gain and postnatal weight retention.
Obesity in pregnancy has serious implications for both the mother and her infant and increases the demand on maternity unit resources. It was reported that of the women who died during pregnancy, childbirth or within 42 days of childbirth between 2009 and 2012, over 22% of them were overweight and 27% obese (Knight et al 2014), consistent with estimates of obesity prevalence amongst women of reproductive age reported by the Health Survey for England (Health & Social Care Information Centre 2013), but higher than previous estimates of obesity prevalence amongst the pregnant population (Heslehurst et al 2010).
Obesity has been shown to be independently associated with higher odds of dying from specific pregnancy complications (Nair et al 2015). These well recognised complications include pre-eclampsia, gestational diabetes, emergency caesarean section and stillbirth (CMACE & Royal College of Obstetrics and Gynaecologists (RCOG) 2010).
The stillbirth rate is higher in babies whose mothers have a body mass index (BMI) ≥ 35kg/m2, that is: 8.6 stillbirths per 1000 singleton births, compared with a general population rate of 3.9 stillbirths per 1000 total births (National Institute of Health and Care Excellence (NICE) 2011). Each unit increase in BMI is associated with a 7% increased risk of stillbirth (CMACE 2010). In addition, the baby faces a higher risk of congenital abnormality, obesity (in later life) and fetal death (Ramachenderan et al 2008).
This article appears in MIDIRS Midwifery Digest, vol 25, no 2, June 2015, pp 225-230.
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