Concerns for overweight pregnant women: A study by University of Melbourne, Australia

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Concerns for overweight pregnant women: A study by University of Melbourne, Australia
 

– Reported,22 January 2013

 

We are certainly seeing more interventions in these women, they are more likely to have caesarean sections or instrumental births or have their labour induced, so that’s having an impact and those babies are more likely to go to the nursery as a result of that. But we are also seeing a more of a social impact as well, so we are seeing women increasingly excluded from other models of care for example, rural or remote maternity units or birth centres or home birth because of their body size.
Dahlen says there is a direct link between obesity in rural regions and therefore models of care need to be re-assessed as well as prevention programs established.

We know that the further you get from the centre of the city, the higher the obesity rate is, so certainly it’s not surprising that in the country we’re finding greater rates of obesity.
For example, if you have got a very large woman, our beds are sometimes not big enough, our doorway, you know you go into an anti-natal room, the chair’s not big enough, you’re then trying to palpate or feel a baby through a larger abdomen, it’s very hard to tell the position of the baby.
We have got a whole lot of issues with skills and equipment and service delivery that haven’t kept pace with the issue that we have got and now on the otherhand we need to start looking at how do we prevent it.

The excess of overweight and obesity in this report might reflect different ways of measuring BMI compared with other studies. There is a lack of consistency in determining BMI in perinatal research, with many reports using estimated prepregnancy weight, while others, as is the case for GVH, use weight measured during the first antenatal visit.

Another potential confounder derives from the role of GVH as a regional referral facility — smaller facilities may transfer women exceeding various BMI thresholds. The effect of the potential transfer of women from small rural centres to GVH appears to be small as, based on postcode data, almost all women lived locally, and of those transferred from another hospital (274), only 47 had class III obesity.

In this cohort, there appears to be a reduction in preterm delivery and small-for-gestational-age births with increasing BMI. Both of these may be advantageous, as they are linked to perinatal mortality. Meta-analyses have confirmed an increased risk of premature delivery with increasing BMI.

CREDITS:

http://www.abc.net.au/
https://www.mja.com.au/
Chris E Cunningham and Glyn R Teale
 
 

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