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Antenatal clinics cut pregnancy risks for obese women, finds study

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Antenatal clinics for severely obese pregnant women can help reduce pregnancy complications, new research has found.

Women who received the specialist care were eight times less likely to have a stillbirth, according to the study, published on BMJ Open.

Academics at the University of Edinburgh’s maternal and foetal health research unit, Tommy’s Centre, said specialist clinics helped healthcare professionals to spot signs of complications earlier so that appropriate treatment could be given.

“Attendance at a specialised antenatal clinic for obesity is associated with reduced rates of stillbirth and…improved detection of gestational diabetes”

Research on specialistic clinic attendance among obese pregnant women

Clinics also helped to identify those who needed to be induced early or have an elective caesarean to help avoid problems during labour, they said.

The research tracked more than 1,000 pregnant women in two NHS hospitals in Lothian between 2008 and 2014 who were classed as being severely obese during pregnancy – with a body mass index of 40 or above.

The study was retrospective and involved analysis of routine data from the NHS’s electronic patient record system.

About half of the women attended a specialist obesity clinic. The others received standard antenatal care.

The women that attended the specialist obesity clinic were treated by a team including obstetricians, specialist midwives, dieticians and other clinical experts.

At their first appointment, between 10 and16 weeks into their pregnancy, the women were reviewed individually by a dietician with specialist and given tailored advice about healthy eating and weight management.

If women attending the specialist clinic had a complication during pregnancy, for example gestational diabetes, it could be treated at the clinic.

“An increasing number of women are overweight or obese when they start having a family and midwives do know they have a critical role to play”

Rona McCandlish

Women who did not attend the specialist service had antenatal care in hospitals or community-based antenatal clinics.

“Attendance at a specialised antenatal clinic for obesity is associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes,” concluded the study authors in the paper, called Does attendance at a specialist antenatal clinic improve clinical outcomes in women with class III obesity compared with standard care?.

“The improvement in clinical outcomes is associated with an increase in healthcare attendance to obstetric triage and clinical interventions including induction of labour and caesarean section,” they added.

The Royal College of Midwives said the study findings underlined the importance of effective team working between health professionals.

“Being obese when pregnant can cause complications for women and their babies and means we should do all we can to offer support and specialist maternity services for these women,” said Rona McCandlish, RCM guidelines and audit advisor.

“An increasing number of women are overweight or obese when they start having a family and midwives do know they have a critical role to play in promoting public health and supporting weight management,” she said.

However, staff shortages mean that many midwives were unable to spend as much time as they required to support and advise women about their weight management, she said.

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