One in five overweight mums had become obese by time they had second child

Call for health service to increase capacity to perform weight-loss surgery

Prof Michael Turner: Maternal obesity is challenging, costly and has lifelong consequences. Photograph: Dara Mac Dónaill

Prof Michael Turner: Maternal obesity is challenging, costly and has lifelong consequences. Photograph: Dara Mac Dónaill

 

One in five overweight mothers had become obese by the time they gave birth to their second child, new Irish research indicates.

Eleven per cent of those whose weight was normal during their first labour were overweight when giving birth a second time, the study of more than 76,000 births at the Coombe hospital in Dublin shows.

The as yet unpublished research was presented by Prof Michael Turner, UCD chair for obstetrics, at a conference on obesity on Thursday, which heard calls for a big increase in the capacity of the health service to perform weight-loss surgery.

Six per cent of the women in the Coombe study who were normal weight or overweight during their first birth had become obese by the time of their second birth. The average gap between the births was about three years.

Prof Michael Turner said maternal obesity was challenging, costly and had lifelong consequences. Obese women were almost twice as likely to give birth to babies with spinal defects, and twice as likely to require a caesarean birth. Venous thromboembolism, another complication of obesity, was the most common cause of maternal mortality in Ireland.

The increase in weight between pregnancies was most pronounced among poorer and older mothers, and among those who had unplanned pregnancies, he said.

A previous study of births at the Coombe showed up to 19 per cent of delivering mothers are obese; this figure has been rising as the average age of mothers increases.

Last year, just 12 bariatric surgeries per million of population were carried out in Ireland, a fraction of the rates in other countries, the conference also heard.

Bariatric surgery is a available in only two of the seven Irish hospital groups, in Dublin and Galway, with no capacity for providing it for children.

In contrast, France delivers 600 surgeries per million of population yearly, Prof Donal O’Shea, HSE clinical lead for obesity, told the conference.

Calling for an immediate building for capacity in bariatric surgery, a report by a Royal College of Physicians in Ireland (RCPI) expert group, says the costs of failing to do so are “incalculable”.

“Given the personal suffering experienced by people who are obese, and the rapidly emerging health system costs in treating an extensive and most distressing range of associated complications of [being] overweight, building further capacity in bariatric surgery is both urgent and essential,” according to the report.

“Further, serious inequality in access to essential surgical services, based on ability to pay, is clearly evident, and is unacceptable.”

“While bariatric surgery is not a complete solution in itself, it is an essential part of a whole-of-health system response, particularly for that substantial minority of people who are seriously overweight, said Prof O’Shea. “It is clearer now that a failure to build capacity in bariatric surgery will lead to increased health costs in both the short and longer term.”

The expert group has called for bariatric surgery to be made available to patients with a body-mass index of 40 or over, or 35 where other serious conditions are involved. The surgery should be available in all hospital groups, with capacity expanded to 200 cases per million within three years.