Obese pregnant women should get special care to reduce stillbirth risk - study


Obese pregnant women should be offered special care to reduce the risk of stillbirth, experts have said.

A new study has found that obese expectant mothers who went to specialist antenatal clinics were eight times less likely to have a stillbirth.

Such clinics may help medics spot signs of complications sooner so that women can be given appropriate treatment.

They also enable health workers to identify women who may need to be induced early or undergo an elective caesarean to avoid problems during labour.

Researchers from the University of Edinburgh tracked more than 1,000 pregnant women who were classed as being severely obese with a body mass index score of 40 or over.

Half the women attended a specialist obesity clinic - which included a team of medics including obstetricians, specialist midwives, dieticians and other clinical experts - while the others received standard antenatal care.

Women who attended the clinic were given tailored advice about healthy eating and weight management during pregnancy. They were also tested for diseases such as gestational diabetes.

Those who developed a complication could be treated in one visit, rather than being referred to a separate specialist clinic at a later date.

The study, published in the journal BMJ Open, found that those who attended the specialist clinic were also less likely to have low-weight babies and more likely to be diagnosed with gestational diabetes.

Around one in five pregnant women in the UK is obese and one in 50 is classed as severely obese.

"Obese women are at high risk of adverse pregnancy outcomes. Our study suggests that multidisciplinary care has potential to improve pregnancy outcomes for mother and baby," said Dr Fiona Denison, honorary consultant in maternal and fetal health at the Medical Research Council Centre for Reproductive Health, University of Edinburgh.

Rebecca Reynolds, Professor of Metabolic Medicine at the University of Edinburgh, who is part of the multidisciplinary team, said: "Early diagnosis and appropriate treatment of diabetes in pregnancy is one way we can improve outcomes for these high-risk pregnant women."

Rona McCandlish, guidelines and audit adviser at the Royal College of Midwives, said: "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.

"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.

"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.

"This is why the RCM's Stepping up to Public Health webpages highlight evidence-based information and tools for women and midwives to help them manage weight in pregnancy and after birth.

"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."