Objective:
To assess the prevalence, trend and impact of overweight and obesity on obstetric outcome in the area drained by Nepean hospital for the years 2005-2016.
Introduction:
Rates of overweight and obesity are continuing to rise in Australia. In 2014-15, 63.4% of Australians aged 18 years and over were overweight or obese (11.2 million people), comprised of 35.5% overweight (6.3 million people) and 27.9% obese (4.9 million people). In 2011-2012, 44% of Australian females aged 18-44 years were overweight or obese. The association between maternal obesity and adverse pregnancy outcomes is well recognized imposing a remarkable burden on fetomaternal health, this is a public health problem that stresses health resources.
Nepean hospital is the referral tertiary hospital for the Nepean Blue mountains local health district where all obese women (>40 BMI) are referred for peripartum care.
Results:
From 2005 to 2015, pregnant mothers classified as normal weight decreased from 48 to 39%, while those classified as obese (BMI 30-40kg/m2) and morbidly obese (>40kg/m2) increased from 25 to 28% and 26 to 37%, respectively. In this cohort, compared to the general population, there was higher stillbirth rate (0.8 cf. 0.6%), hypertensive disorders (9 cf. 2-3%), diabetes (17 cf. 15%), caesarean sections (47 cf. 33%), post-partum haemorrhage (18 cf. 11%) and admissions to ICU (3.0 cf. 0.4%).
Consensus:
In our cohort there is alarming increase in the number of obese and morbidly obese pregnant women entering our service. This has been associated with more obstetric adverse outcomes. To date, this has stimulated the allocation of resources, community motivation and provision of new health services (OPAL) aiming to optimize feto-maternal outcome. More will need to be done at the community level to help address increasing rates of obesity in those of child-bearing potential.