OBESITY IN PREGNANCY

Obesity in Pregnancy



Table of Contents

CHAPTER I4

Introduction4

Chapter II7

Introduction7

Methods7

Findings8

Incidence of obesity9

Obesity in relation to age9

Obesity in relation to ethnicity10

Obesity and social deprivation11

Obesity and antenatal complications12

Mode of birth13

Indication for mode of birth14

Fetal macrosomia15

Outcomes where no differences were demonstrated16

Chapter III18

Literature Review18

Introduction18

Obesity: maternal health outcomes19

Maternal medical disorders during pregnancy19

Maternal perinatal and postpartum issues19

Maternal obesity: neonatal outcomes20

Macrosomia20

Preterm delivery21

Antepartum stillbirth22

Perinatal morbidity22

Birth defects23

Long-term childhood obesity23

Service delivery implications24

Improving outcomes for obese pregnant women and their infants: an economic assessment25

Maternal obesity: interventions and costs26

Preconception counselling26

Interventions targeting obesity in pregnancy27

Reducing pregnancy complications in obese women: the role of extra care28

Interconception care29

Resource costs of obesity in pregnancy29

Health consequences of obesity in pregnancy30

Decision-making31

2. Summary33

CHAPTER IV35

Discussion35

Further work41

CHAPTER V42

Conclusion42

References43

CHAPTER I

Introduction

Obesity is a non-communicable disease that has come to outbreak percentages, and its occurrence in the UK has trebled since the 1980s (Department of Health, 2004a). Body mass catalogue (BMI) is utilised to assess obesity, and is characterised as the ratio of body heaviness in kilogramme split up by the rectangle of size in metres (World Health Organization, 2000). An attractive BMI is between 19 and 2A BMI between 25 and 29. Is advised overweight and an obese BMI is overhead 30 (National Institute for Health and Clinical Excellence, 2006). Over half of all mature individuals in the UK are now either overweight or obese, which is matching to 24 million mature individuals (Department of Health, 2004a).

Obesity is a foremost public well-being topic in the evolved world, and it is a increasing dispute for the UK Government because of its direct assistance to infections, for example diabetes mellitus, hypertension, high blood cholesterol and coronary heart disease (Sheiner et al., 2004). The White Paper, Choosing Health (Department of Health, 2004b, p. 4) recognises 'reducing obesity and advancing diet and nutrition' as one of its six main concerns, identifying that the fast boost in obesity grades is saving up important, promise well-being difficulties for the future.

Obesity sways one-fifth of the feminine community in the UK (Lashen et al., 2004), and the Confidential Enquiry into Maternal and Child Health proposes obesity to be one of the utmost risks to childbearing women. It accounts that more than half of all women who past away between 2003 and 2005 were either overweight or obese, and 15% of killings were in women with a BMI overhead 35 (Lewis, 2007).

Obesity has been broadly studied, with many released items and government articles considering it as a public well-being issue. A comprehensive, methodical publications reconsider of five health-care databases (CINAHL, EMBASE, MEDLINE, PsychLit and British Nursing Index) was performed. The most of investigations recognised were of quantitative methodology and from the USA, the United Arab Emirates and Scandinavia. Only three investigations from the UK were recognised (Sebire et al., 2001; Lashen et al., 2004; Heslehurst et al., 2006), the last cited was a qualitative study discovering well-being professionals' individual know-how of supplying maternity care to obese women.

There is a increasing body of clues proposing that obese with child women are at larger risk of several maternal and fatal difficulties of pregnancy, encompassing pre-eclampsia, ...