Research and Enterprise, Issue 9 - University of Teesside

Research and Enterprise
18
Weight worries
for mums-to-be
Being seriously overweight during pregnancy increases dangers for both
mother and unborn child, but little is being done to help obese mums-to-be, as
LIZ LIGHTFOOT finds out from talking to Teesside researcher Nicola Heslehurst.
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Maternal obesity has more than doubled over
the last two decades, with one in six pregnant
women now facing extra risks to themselves
and their babies.
The proportion of women classified as obese
on first contact with the maternity services went
up from 7.6% in 1989 to 15.6% in 2007, according
to the first England-wide study of around 620,000
births.
More than half the women who die in
pregnancy or childbirth are obese or overweight.
Being seriously overweight increases the
likelihood of conditions such as cardiac disease,
diabetes and pre-eclampsia, and can be a
contributing factor in stillbirth, congenital
anomalies and prematurity.
But very little is being done nationally to
support women in achieving a healthy weight
before bearing children, according to a leading
researcher in the field.
Once obese women become pregnant there
are still things they can do to minimise the
potential for complications for themselves and
their babies, such as healthy eating and
moderate levels of physical activity. Despite the
potential risks, there is no strategic public
information campaign, says Dr Nicola Heslehurst
from Teesside University’s Health and Social Care
Institute.
Dr Heslehurst’s study of births around the
country – published in the International Journal of
Obesity 2010 – found wide regional variations for
maternal obesity, ranging from just over 13% in
London to nearly 22% in the West Midlands.
She went on to lead a team of academics
from the Universities of Teesside, Newcastle and
Durham on a research project on the provision of
clinical and support services for obese pregnant
women.
The study, funded by Public Health North
East and published in the journal Midwifery last
summer, found improvements to obesity services
at North East maternity units over the last four
years. The advances related mainly to health and
safety, such as the provision of more suitable
equipment, including sturdier beds and operating
tables.
However, the lack of services to help mothers
tackle their weight problems had still not been
addressed, and there was a lack of partnership
working between public health and maternity
services. No weight-gain guidelines were in place,
for example. ‘Mothers were being told they were
putting their babies at risk and were then left to
deal with it themselves, largely due to a lack of
national guidelines for this type of advice and
support for women,’ says Dr Heslehurst.
The lack of weight-management services
and weight-gain guidance made it difficult for
midwives to discuss obesity with women during
pregnancy. ‘Midwives seek to build up a good
relationship with women and they struggle to
know how to initiate discussions with them about
their weight as it is such a sensitive issue,’ says
Dr Heslehurst.
‘There is an urgent need for obesity training for
midwives and better communication between the
public health and maternity services,’ she says.
Lessons could be learned from the
development of smoking cessation services
during pregnancy, she suggests. Midwives
participating in the study felt that the national
drive for smoking cessation with its structured
training, support and funding had worked
successfully, whereas previous local initiatives
without that level of strategic support had failed.