The health of pregnant women and their babies is jeopardised when the mothers are obese or underweight, according to a new study that also points to the growing financial costs to the NHS.
The number of women who are obese during pregnancy continues to rise, say the authors of a study published in BJOG: An International Journal of Obstetrics and Gynaecology.
An analysis of the pregnancies of nearly 110,000 women in Scotland between 2003 and 2010 finds that the risk of complications increase in women with a higher body mass index (BMI) – a measurement relating weight to height. Compared to normal weight women, severely obese women (with a BMI over 35) have a threefold increased risk of hypertension (raised blood pressure that is dangerous in pregnancy) and gestational diabetes, which can affect mother and baby.
Underweight and overweight women are more likely to be re-admitted to hospital with problems after the birth – underweight women (BMI below 18.5 and more often smokers) are 8% more likely than normal weight women to be re-admitted, while overweight, obese and severely obese women are 16%, 45% and 88% more likely to return, the study finds.
The authors say that the NHS could save money by helping women attain a normal weight before pregnancy. If, for example, there were a reduction of 2.5% in the proportion of overweight and obese pregnant women in Scotland, increasing the normal weight population by 5%, and the corresponding drop in admission costs were extrapolated to the UK as a whole, "the anticipated cost savings to the UK for inpatient admissions alone would be £12,702,278". The better health of the babies and mothers in the long term would add to the savings.
"We know that maternal obesity is a major cause of ill health in pregnancy in the UK, significantly increasing the risk of adverse medical outcomes such as gestational diabetes, hypertensive disorders and admissions for specialist care," said Mike Marsh, BJOG deputy editor-in-chief.
"This study confirms these risks and in addition highlights the financial burden to the NHS of obesity in pregnancy.
"It is vital that women understand the importance of maintaining a healthy weight prior to conception to reduce the risk of future pregnancy complications, the need for specialist care and the resulting cost to the NHS."
