Fit for Birth – the effect of weight changes in obese pregnant women on maternal and neonatal outcomes: a pilot prospective cohort study

Abstract

What is already known about the subjectMaternal obesity is a risk factor for adverse maternal and foetal perinatal outcomes.The Institute of Medicine gives recommendations for weight gain during pregnancy based on initial body mass index (BMI) category, but the effects of these weight changes on pregnancy outcomes has not been adequately described. What this study adds: This study supports an association between gestational weight gain and adverse outcomes in obese pregnant women. Older and primiparous women in the cohort had the highest rates of weight gain, while socioeconomic deprivation did not influence weight changes. Women were recruited into the study at their antenatal booking visit and had weights measured throughout pregnancy. Patterns of weight gain were described and related to maternal and neonatal outcomes.Main outcome measure: The primary outcome was a composite measure consisting of any of twelve adverse maternal and fetal outcomes. This was compared by categorised pregnancy weight gain (<0 kg, 0-5 kg, 5.1-9 kg and >9 kg). patterns of weight gain varied widely and missing data was common and non-random.There was a significant association between increased weight gain during pregnancy and poor maternal and fetal outcome.Conclusions: Weight gain in obese women during pregnancy can be highly variable. Our study supports an association between increased weight gain in pregnancy and adverse perinatal outcomes.

A qualitative study exploring midwives' perceptions and knowledge of maternal obesity: Reflecting on their experiences of providing healthy eating and weight management advice to pregnant women

“…The adverse effects associated with excessive GWG have been widely reported (Fraser et al, ; Narayanan et al, ). However, the UK has no guidance on the amount of weight that should be gained during pregnancy.…”

“…and some acknowledged that they could offer weight management information to those with a BMI of 38 kg/m 2 but not for those with The adverse effects associated with excessive GWG have been widely reported (Fraser et al, 2010;Narayanan et al, 2016). However, the UK has no guidance on the amount of weight that should be gained during pregnancy.…”

“…It is recommended that all women presenting for maternity care services should receive healthy eating advice from midwives (NICE, ) and those with a BMI ≥30 kg/m 2 should be offered a structured weight loss programme following childbirth (NICE, ). However, Narayanan et al () suggest that women's weight management issues and needs for support differ, depending on their BMI status. Moreover, there is international variation in clinical guidelines for GWG; the most widely applied in clinical practice are those published by the American Institute of Medicine (IOM and the National Research Council [NRC], ).…”

Screening methods for obstructive sleep apnoea in severely obese pregnant women

“…The mean age was 29.6 (range 18–43, SD 6.1), and median BMI was 38 (range 35–68.6; Table ). Full details of the cohort are published elsewhere .…”

“…The Fit for Birth study was a cohort study of pregnant women with a BMI of ≥30. Detailed information is available elsewhere, but in brief, 824 women were recruited over a 1‐year period in a large tertiary referral hospital in the northwest of England . Data were collected for all those in the study who subsequently gave birth at the trust.…”