- The Guardian
- Tuesday December 4 2007
Obesity is a growing risk factor in the deaths of women during pregnancy or childbirth, according to a report published today. A total of 295 women died while pregnant or giving birth in the UK between 2003 and 2005. More than half of those were either overweight or obese and more than 15% were extremely obese, according to an investigation carried out under the auspices of the medical Royal Colleges together with the National Patient Safety Agency.
"Obesity is fast emerging as the public health issue of our generation and its impact on maternity must be taken seriously," said Prof Sabaratnam Arulkumaran, president of the Royal College of Obstetricians and Gynaecologists.
"Maternity services are already struggling to cope with the increasing birth rate. Maternal obesity places more pressure on existing resources."
The confidential inquiry into maternal and child health (Cemach), set up by the colleges, which reviews maternity care every three years, found that women in the poorest circumstances were seven times more likely to die than the rest.
They were in worse general health than others and were far less likely to have regular contact with maternity services. Among them would be refugees and asylum seekers.
The report says the proportion of women who committed suicide has dropped substantially since the last triennial report covering 2000-02 and is no longer the leading cause of death. It suggests this may be a result of earlier recommendations that those at risk be identified and supported during the period after the birth of their baby.
Obesity is now the chief concern. It represents, says the report, "one of the greatest and growing overall threats to the childbearing population of the UK". The most frequent causes of death were blood clots, sepsis and heart disease.
Six women who died had a body mass index, which measures height against weight, of more than 45 (above 30 is considered obese) and two exceeded 60.
"Such severe obesity not only compromises a mother's underlying general health but also causes logistical problems," says the report.
Resuscitation was delayed in one case because ambulance staff were unable to remove a woman from her house. There were a few cases where a caesarean section had to be performed on two beds pushed together because the women's weight exceeded the safe level for the operating table.
The report recommends better counselling and support for pregnant women who are obese or have pre-existing medical problems such as diabetes and epilepsy.
"The report clearly shows the impact that a mother's overall health has on the outcome of her pregnancy," said Gwyneth Lewis, director of the maternal deaths inquiry.
"Healthy mothers have healthier pregnancies and healthier babies. The fact that more than half of the women who died were obese or overweight, and that preventable causes of cardiac disease were the leading cause of death, shows that strong public health messages are needed both before and during pregnancy."