Proceedings of the Nutrition Society

A Meeting of the Nutrition Society, hosted by the Scottish Section, The Teacher Building, 14 St Enoch Square, Glasgow.5–6 April 2011,

70th Anniversary Conference on ‘Nutrition and health: from conception to adolescence’

Symposium I: Consequences of obesity and overweight during pregnancy

Identifying ‘at risk’ women and the impact of maternal obesity on National Health Service maternity services

Nicola Heslehursta1 c1

a1 Health and Social Care Institute, Parkside West Offices, Teesside University, Middlesbrough TS1 3NN, UK

Abstract

Obesity is a public health concern worldwide, arising from multifaceted and complex causes that relate to individual choice and lifestyle, and the influences of wider society. In addition to a long-standing focus on both childhood and adult obesity, there has been more recent concern relating to maternal obesity. This review explores the published evidence relating to maternal obesity incidence and associated inequalities, the impact of obesity on maternity services, and associated guidelines. Epidemiological data comprising three national maternal obesity datasets within the UK have identified a significant increase in maternal obesity in recent years, and reflect broad socio-demographic inequalities particularly deprivation, ethnicity and unemployment. Obese pregnancies present increased risk of complications that require more resource intensive antenatal and perinatal care, such as caesarean deliveries, gestational diabetes, haemorrhage, infections and congenital anomalies. Healthcare professionals also face difficulties when managing the care of women in pregnancy as obesity is an emotive and stigmatising topic. There is a lack of good-quality evidence for effective interventions to tackle maternal obesity. Recently published national guidelines for the clinical management and weight management of maternal obesity offer advice for professionals, but acknowledge the limitations of the evidence base. The consequence of these difficulties is an absence of support services available for women. Further evaluative research is thus required to assess the effectiveness of interventions with women before, during and after pregnancy. Qualitative work with women will also be needed to help inform the development of more sensitive risk communication and women-centred services.

(Online publication August 22 2011)

Correspondence

c1 Corresponding author: Dr Nicola Heslehurst, fax +44 1642 342758, email n.heslehurst@tees.ac.uk