Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15‐year period

Abstract

Objective The aim of this study was to identify trends in maternal obesity incidence over time and to identify those women most at risk and potential-associated health inequalities.Design Longitudinal database study.Setting James Cook University Hospital maternity unit, Middlesbrough, UK. Methods Trends in maternal obesity incidence over time were analysed using chi-square test for trend. Demographic predictor variables were analysed using multivariate logistic regression, adjusting for confounding factors after testing for multicollinearity. National census data were used to place the regional data into the context of the general population.Main outcome measure Trends in maternal obesity incidence. Demographic predictor variables included ethnic group, age, parity, marital status, employment and socio-economic disadvantage.Results The proportion of obese women at the start of pregnancy has increased significantly over time from 9.9 to 16.0% (P < 0.01). This is best described by a quadratic model (P < 0.01) showing that the rate is accelerating; by 2010, the rate will have increased to 22% of this population if the trend continues. There is also a significant relationship with maternal obesity and mothers' residing in areas of most deprivation (odds ratio [OR] = 2.44, 95% CI = 1.98, 3.02, P < 0.01), with increasing age (OR = 1.04, 95% CI = 1.04, 1.05, P < 0.01), and parity (OR = 1.17, 95% CI = 1.12, 1.21, P < 0.01).Conclusions The incidence of maternal obesity at the start of pregnancy is increasing and accelerating. Predictors of maternal obesity are associated with health inequalities, particularly socio-economic disadvantage.

A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007

“…The increasing rates of maternal obesity supports previous research carried out in the UK at the individual maternity unit level, [8][9][10] although the actual proportions vary. The increase in the proportion of women who are obese over time has important implications.…”

“…10 Previous research hypothesised that this may be related to physiological factors hindering fertility in the obese population, and may explain the existence of a lag effect identified in this study. There is a relationship between obesity and foetal loss, 4 and this study used data on completed pregnancies rather than all pregnancies, because of the need to calculate the gestational age at booking from the gestational age at delivery.…”

“…Previous research identified a lag effect between obesity in the pregnant population when compared with the general population of women of childbearing age. 10 This phenomenon was potentially due to the exclusion of late bookers, which theoretically included a large proportion of the target population of obese women in pregnancy. This study adjusted for naturally incurred weight gain of late bookers (women who booked after their first trimester) using published data on BMI change per gestational week 16 rather than excluding late bookers and potentially excluding a large proportion of the obese population.…”

“…10 The scale of obesity in the pregnant population on an international level has also been summarised as being between 1.8% and 25.3% according to data from published studies. 11 However, there are difficulties with direct comparison of the international data because of the variation in the definition of obesity, the differences in time periods of the published studies, and the majority of studies representing regions of the United States and Australia.…”

Índice de massa corporal e ganho de peso gestacional como fatores preditores de complicações e do desfecho da gravidez

“…Um estudo retrospectivo realizado com mulheres inglesas demonstrou um aumento nas taxas de obesidade de 9,9%, em 1990, para 16% em 2004, com projeção para 22% em 2010 24 . Admite-se que 19 a 38% das gestações ocorrem em mulheres com sobrepeso ou obesas 25 .…”