Does specialist care reduce the number of stillbirths?

Care of severely obese women at Tommy's specialist antenatal metabolic clinic reduces the number of stillbirths eight times

The specialist multidisciplinary Antenatal Metabolic Clinic established with the help of Tommy’s in 2008 has now looked after more than 1,000 severely obese women throughout their pregnancies. This care includes regular and frequent check-ups of the mother and baby, personalised advice about healthy eating, and education about the increased risks that obesity causes in pregnancy. In 2015, we compared around 510 women who attended our specialist clinic with 494 women who received standard antenatal care. The women at our clinic had higher risk pregnancies as they were more obese and were also more likely to be having their first pregnancy.

We found that women who received specialised care were 8 times less likely to have a stillbirth.

We found that women who received specialised care were 8 times less likely to have a stillbirth.The rate of stillbirths was 2 per 1,000 deliveries, which is lower the rate for Scotland overall (3.2 per 1,000 in 2015), and less than a third of the Scottish average for severely obese women (7 per 1,000). There were no stillbirths at all in the clinic over 2016. Women attending the clinic were less likely to have a baby of low birthweight (less than 2.5 kg). They were also more likely to be tested for diabetes, allowing the condition and the pregnancy to be managed appropriately if it is diagnosed. This study shows that this level of extra care for severely obese women reduces the risk of stillbirth. 

Researchers

Rebecca Reynolds, Fiona Denison, Jane Norman

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Funding

Tommy's funded the set-up of the clinic and continues to support the staff and research taking place there

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