Women who are obese have a greater risk of developing complications during pregnancy, and obesity may also affect the long-term health of the baby and future generations.
Little is known about the physiological and hormonal changes that occur in very severely obese women (body mass index [BMI] of 40 or higher) during pregnancy and how these changes affect the development of the baby, and subsequent obesity or metabolic risk.
We do not know which advice about weight-management to give these women to ensure the best outcomes for both them and their babies. The Edinburgh Antenatal Metabolic Clinic was established in 2008 to address such questions.
The clinic provides multidisciplinary antenatal care to severely obese pregnant women, including advice about diet and lifestyle.
We are also carrying out a detailed study of the women who attend our clinic to look at their weight gain and change in body composition during pregnancy, and how this affects their babies.
Progress report 2017
More than 400 women have now received antenatal care at the clinic and we have published (and continue to publish) findings from our work. We have already shown that severely obese women who attend our clinic have better clinical outcomes than women who don’t.
In particular, a recent audit showed that severely obese women cared for by this clinic had a significantly lower rate of stillbirth. They are eight times less likely to have a stillbirth than similarly obese women who do not attend the clinic.
Women who attend the clinic are 8 times less likely to suffer a stillbirth
We have also followed up the babies of almost 200 of our very severely obese women. These babies were significantly heavier and shorter at birth than the babies of normal-weight women, and were still significantly heavier at 6 months of age. This may be related to less breast feeding and the early introduction of solid food, which may affect obesity later in childhood. To look at this, we are assessing the growth of these children (who are now aged between 3 and 7 years) and the development of obesity and any metabolic problems.
Progress report 2018
Our clinic has continued to expand over the years and we now provide evidence based personalised antenatal care to 25-30 women every week. This year we have surveyed women attending the clinic to get feedback from them about their experiences of attending the clinic.
We have also been:
- focusing on the health of women with gestational diabetes who attend the clinic
- looking at ways to reduce the time that women spend in sedentary activities
- exploring how maternal obesity influences the type of anaesthetic women get for caesarean section.
This year we held an ‘MRC Festival Day’ to show-case our work to members of the public. It was really well attended and received excellent feedback. Tommy’s was also visited by Aileen Campbell, MSP and Minister for Public Health and Sport.
The clinic has been used as an exemplar in the development of the first Green- Top Guideline produced by the Royal College of Obstetricians & Gynaecologists to guide management of obesity in pregnancy. Fiona Denison is Chair of this Guideline Development Group, and has been working with a multi-professional group including Rebecca Reynolds to generate the guideline, which is due to be published in October 2018.
Thanks for your interest in our research
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