Obese Pregnant Women - The Health Risks

In a study carried out by the Centre for Maternal and Child Enquiries (CMACE) "Maternal Obesity in the UK: Findings from a national Project" reveals that one in twenty women are seriously obese when they become pregnant putting their health and that of their baby at risk.

In 2008 the CMACE commenced a three year UK wide Obesity in Pregnancy project.  The project was initiated because of the growing concerns surrounding obesity and the challenge facing maternity services today.  These concerns included i) growing evidence that obesity is associated with increased morbidity and mortality for both mother and baby, ii) that women with obesity were over represented among those who died of direct deaths compared to those who died of indirect deaths, iii) the need for clinical guidance for the care of women with obesity in pregnancy.

The study looked at women who had a body mass index of 35 or more, with 18 to 25 classed as healthy, 25
30 classed as overweight and 30 to 35 obese.  A woman of average 5'5 height would weigh at least 15 stone or 95 kgs to have a BMI of 35 and be classed as severely obese. 

Evidence derived from the report highlighted that women with obesity have an increased risk of pregnancy-related complications and adverse outcomes compared to women with a healthy BMI.  These primarily include higher levels of fetal abnormality, hypertensive disorders, blood pressure problems, diabetes thrombosis, induction of labour, caesarean section and neonatal death.  The report highlighted that stillbirth rate was twice as high for women with a BMI of 35 or more and they were four times as likely to suffer a haemorrhage after birth. 

However, the report also revealed that despite the large number of obese women, maternity units are "under prepared" and do not have the necessary resources to care for obese pregnant women.  It was reported that there is a lack of extra wide wheelchairs, examination couches, trolleys and beds.  With almost one in five obstetric units not having operating tables to bear the extra weight.

Dr Imogen Stephens, CMACE Clinical Director said: “This CMACE report shows that much more needs to be done in the NHS to deal with the growing numbers of obese pregnant women."

"The findings from this new study show that the risks of clinical intervention increase with increasing levels of obesity and that specialist obstetric care is needed. All this requires improved, and better integrated, care for these women”. 

However, the CMACE report also recommended that GP's and primary care health professionals need to do more to encourage women to lose weight and adopt a healthier lifestyle before they conceive. 

Dr Tony Falconer, President of the Royal College if 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.
"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."

Professor Cathy Warwick, General Secretary of the Royal College of Midwives said “There is wider and long-term public health message here. There is a real need to reduce obesity in the population as a whole, tackling the issue before women become pregnant.”

To read the full CMACE report please click here