Warning over ‘epidemic of obesity’ in pregnant women

HEALTH professionals in Britain are dealing with “an epidemic of obesity” among pregnant women as weight gain across the wider population continues to rise, experts have warned.

About half of women of childbearing age are either overweight (with a BMI of 25-29.9) or obese (with a BMI of 30 or above) and approximately 16% of women in England are obese from the start of pregnancy, according to the National Institute for Health and Clinical Excellence (Nice).

The organisation launched new public health guidance yesterday on weight management before, during and after pregnancy, in the face of growing evidence concerning female obesity and the related risks it poses for both the mother and baby.

Professor Lucilla Poston, director of maternal and fetal research at King’s College London, said: “These guidelines are incredibly timely, we have an epidemic of obesity amongst our pregnant population.

“At St Thomas’ recently we looked at our stats and there has been an exponential increase in obesity amongst our women attending ante-natal clinics, such that now 40% of the women are overweight or obese, and in the UK the best statistics we have suggests between 15% and 20% of pregnant women are coming into pregnancy with a BMI which is less than ideal.”

She added that obese women were at increased risk of “almost every complication in the book in pregnancy”.

Potential complications included impaired glucose tolerance and gestational diabetes, miscarriage, pre-eclampsia, thromboembolism and maternal death.

Research also suggested that obese women were more likely to have an induced or longer labour, instrumental delivery, caesarean section or a postpartum haemorrhage.

There were also practical implications for obese pregnant women, with reduced choices on how and when they gave birth and possible restrictions on home and water births.

Babies born to obese women faced significant health risks such as a higher risk of death, stillbirth, congenital abnormality, shoulder dystocia — where a baby’s shoulder becomes stuck — and the potential for a baby to be too large for their gestational age, increasing the likelihood of obesity in childhood.

Obese women also sometimes faced problems with breast-feeding.

The guidelines outlined the importance for women in achieving a healthy weight and BMI prior to pregnancy and stressed there was no need to “eat for two”.

The document also advised against females trying to lose weight or go on a “crash diet” during pregnancy.

It stressed the need to provide women with advice on reducing their weight safely after childbirth, with information on healthy eating and exercise or a structured weight loss programme for those with a BMI of 30 or more.

Professor Annie Anderson, Professor of Food Choice at the University of Dundee’s Centre for Public Health Nutrition Research said: “All around us adults are getting bigger. It’s not just pregnant women — everywhere in society, and that does include women of child-bearing age.

“It’s estimated that, over the last 20 years, the number of women entering their pregnancy in the obese category has doubled. It’s time to take stock about what to do about that.”

She added: “Pregnancy is absolutely not the time to diet or lose weight... but neither is it desirable to eat for two. That’s one of myths that’s out there, people say ‘Forget about it’ and that really isn’t the case.”