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Confidential Enquiry into Maternal and Child Health

Improving the health of mothers, babies and children


Overview Maternal and Perinatal Health
Maternal & Perinatal Mortality Surveillance
Saving Mothers' Lives
Obesity in Pregnancy
Near term Intrapartum death & Neonatal Encephalopathy
Diabetes in Pregnancy
BEADI
CEMACH/UCL Diabetes Project
Local clinical audits

Child Health
New Child Health Enquiry Topic
Child Death Review
Confidential Enquiry into Head Injury in Children

Obesity in Pregnancy

Summary

Obesity in Pregnancy has been selected as CEMACH’s principal project with a maternal health focus for 2008-2011. 

There is substantial evidence that obesity in pregnancy contributes to increased morbidity and mortality for both mother and baby. For example, the CEMACH Maternal Death Enquiry (Why Mother’s Die) found that approximately 35% of women who died (who had a recordable Body Mass Index) in the 2000-2003 triennia were obese (i.e. had a BMI of 30 or greater). The CEMACH Perinatal Mortality 2005 Report found that approximately 30% of the mothers who had a stillbirth or a neonatal death were obese.

Increased rates of obesity related morbidity and mortality are reflected in increased social and financial costs:
  • Obese women spend an average of 4.83 more days in hospital and the increased levels of complications in pregnancy and interventions in labour represent a 5 fold increase in cost of antenatal care (Galtier-Dereure et al, 2000)
  • The costs associated with newborns are also increased, as in babies born to obese mothers there is a 3.5 fold increase in admission to Neonatal Intensive Care Unit (NICU)  

There is currently no single national clinical guideline available in the UK with regard to clinical care in obesity in pregnancy. Additionally, it is unclear whether recommendations from research based on the clinical care of obese women are being followed in maternity units or further, what the impacts of following such recommendations are.

Aims and objectives of the CEMACH Study
 
The CEMACH obesity project seeks to gain an overview of current service provision for obese women in pregnancy and to identify any gaps that may exist in the provision of care to obese women. A primary output of the project will be the production of a set of recommendations for healthcare providers, commissioners and policy makers on ways to improve the management of pregnant women with obesity and hence the outcomes for these women and their babies. CEMACH has chosen to focus this study on women with a BMI of 35 and over, primarily because recommendations for care for this group of women are likely to be easier to implement, and because the impact of such recommendations is likely to be more substantial in terms of improved outcomes.
 
Specifically the CEMACH obesity in pregnancy project is interested in determining:
  • The prevalence of obesity (BMI of ≥35) in pregnancy in the UK
  • Whether health care services in the UK are appropriately organised for the care of pregnancy women who are obese
  • Whether standards of care for obesity in pregnancy are being met and what the outcomes are for women and their babies who do/do not have these standards met

Methodology

In brief, the enquiry will comprise: 

  • An organisational survey investigating how well individual units are equipped to care for women with obesity (BMI of 35)
  • The development of a set of auditable standards for the care of obese women
  • An audit of the care provided to a cohort of obese women who have give birth utilising the consensus standards previously developed  
Planned completion for the project is March 2011.
 

For further information on this study, please contact Dr Jo Modder or Kate Fitzsimons on 020 7486 1191.

Obesity in Pregnancy Audit Postcode Converter & BMI Calculator

Postcode converter - http://www.cemach-infosearch.org.uk/

BMI Calculator - http://www.cemach-infosearch.org.uk/bmi.aspx

 


Publications Information


Data Collection Forms and other useful documents

CEMACH Obesity and Maternity Services Survey (Final Electronic Version)