Specialist antenatal clinics for severely obese mothers-to-be can help cut rates of pregnancy complications, new research has found.
Women who received the specialist care delivered by expert midwives and others were eight times less likely to have a stillbirth, according to the study by the University of Edinburgh.
“Multi-disciplinary care has potential to improve pregnancy outcomes for mother and baby”
Researchers tracked more than 1,000 pregnant women classed as being severely obese during pregnancy, because they had a body mass index (BMI) of 40 or above.
Around half the women attended a specialist obesity clinic, while the others received standard antenatal care.
Those that attended the obesity clinic were treated by a team that included obstetricians, specialist midwives, dieticians and other clinicians.
They were given tailored advice about healthy eating and weight management during pregnancy, and were tested for diseases such as gestational diabetes.
The service meant women who developed a complication could be treated in one visit, rather than being referred to a separate specialist clinic at a later date.
“An increasing number of women are overweight or obese when they start having a family”
The study, published today in in the journal BMJ Open, was carried out by researchers at the Tommy’s Centre for Maternal and Fetal Health at Edinburgh University.
“Obese women are at high risk of adverse pregnancy outcomes. Our study suggests that multi-disciplinary care has potential to improve pregnancy outcomes for mother and baby,” said study author Professor Rebecca Reynolds.
“Early diagnosis and appropriate treatment of diabetes in pregnancy is one way we can improve outcomes for these high risk pregnant women,” she said.
Responding to the study, the Royal College of Midwives agreed that effective multi-disciplinary working was key when it came to ensuring overweight women got the best care during pregnancy.
“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, the college’s guidelines and audit advisor.
Expert midwives answer to tackling obesity in pregnancy
“Effective team working by midwives, doctors and other health professionals has long been recognised as leading to better outcomes for women and this has again been highlighted in this study,” she added.
But she also highlighted the fact that over-stretched midwives did not always have the time they would wish to advise women on weight issues.
“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,” said Ms McCandlish.
“However, we also know that many midwives are tremendously pressed because of staff shortages and find they are unable to spend as much time as they need to support and advise women about their weight management,” she said.
The RCM has produced information and tools for midwives on weight management during and after pregnancy as part of its Stepping Up to Public Health project.