Why do we need this research?
Approximately one in five pregnant women have obesity. Although obesity is linked to complications during pregnancy and birth, many obese pregnant women have straightforward, uncomplicated births. Despite this, nearly all obese women are asked to give birth in hospital where they can be cared for by doctors and midwives, just in case something goes wrong.
We think it should be possible to work out which obese but otherwise healthy pregnant women are likely to have uncomplicated pregnancies and vaginal births, so that these women can be given the opportunity to give birth in a midwife-led birth centre.
What happened in this project?
To help do this, our researchers looked at a large Canadian database that included over 700,000 women to see if there were any particular characteristics that seemed to be linked to uncomplicated pregnancy and birth. Of these women, 120,000 were obese.
The team found that among those obese pregnant women who had either no pre-existing medical conditions or no complications identified early in pregnancy, nearly 60% went on to have uncomplicated pregnancies. In women of a healthy weight, this figure was close to 75%. They also found that obese pregnant women with no early complicating factors were more likely to have an uncomplicated pregnancy is they had given birth previously, were younger, more affluent, were of white or black ethnicity, and had a lower weight. These women were also more likely to have uncomplicated pregnancies if they had normal levels of a hormone called pregnancy‐associated plasma protein A (PAPP‐A) or if they had conceived naturally.
Further research is now needed to develop and test a predictive tool that incorporates these factors with others such as ultrasound meaasurements in order to help health professionals work out which obese pregnant women are most likely to have uncomplicated pregnancies and births.
What difference will this project make?
This project should help give obese women peace of mind that they are not likely to have any problems during their pregnancy. It will also help doctors focus specialist care to the women who really need it.