Sharp rise in severely obese mothers giving birth ‘concerning’

A sharp rise in the number of severely obese mothers delivering babies in many Irish maternity hospitals is causing concern among doctors.

The number of severely obese mothers attending the Coombe maternity hospital in Dublin grew by 48.5 per cent between 2009 and 2013, according to a recently published study. The Rotunda hospital has also seen a big increase in morbid obesity among its patients.

Obese mothers are more likely to suffer from high blood pressure, diabetes and haemorrhaging after birth, and to require delivery by Caesarean section. Their children are at increased risk of being stillborn or delivered early and to experience obesity in later life.

The Coombe study found it was “concerning” that while the overall obesity level among mothers remained stable, the number of cases of severe obesity increased.

“The major increase in the absolute number of women classified as severely obese is a concern not only in terms of increased clinical risk but also in terms of the increased in technical challenges and economic costs for the maternity services,” say researchers from the Coombe and UCD’s centre of human reproduction.

The obesity rate among mothers from the 13 EU accession countries (mostly in Eastern Europe) was half that of mothers born in existing EU countries.

Rates of obesity increase with the age of the mother and the number of previous children she has had. It is highest among unemployed and low-skilled women and smokers.

Maternity hospitals

The study says greater efforts to address the problem need to be made as a priority before women become pregnant. “We also recommend that after delivery of a woman’s first baby, previous efforts to optimise her weight should be reinforced.”

The HSE says it does not collect data about maternal overweight and obesity on a national level and it depends on individual hospitals to do this. Figures published annually by the three Dublin maternity hospitals, which account for more than half of all deliveries in any given year, indicate rates of overweight and obesity among patients stabilised in 2014, albeit at a very high level. More than four out of every 10 women were above recommended weight.

In the Rotunda hospital, there was a rise in the number of overweight and obese women over the previous year, to 26.7 per cent and 14.7 per cent respectively.

Rates at the National Maternity Hospital (NMH) were marginally better, but are also increasing –last year, 24.8 per cent of women were overweight and 12 per cent were obese.

NMH master Dr Rhona Mahony said morbidly obese mothers were at greater risk of miscarriage, birth defects and were more likely to have large babies who would go on to have health issues. "We're programming their children to have a difficult time in later life."

Treating obese mothers also posed challenges for doctors, from obtaining results from ultrasounds to administering anaesthesia. Dr Mahony said obese women were encouraged to lose weight during pregnancy as it was “never too late” for them to switch to a good diet with less sugar intake.

She also stressed the importance of obese women taking high-dose folic acid to minimise the risk of birth defects.

Rates at the Coombe dropped slightly from 2013, when the study finished, to 2014, when 26.8 per cent of women were overweight and 15.3 per cent were obese.

Two per cent or less of women in each hospital were recorded as underweight.