Ailsa Millen Healthy Lifestyle Midwife A Big Problem One fifth of pregnant women in the UK are obese Maternal obesity has become one of the most commonly occurring risk factors in obstetric practice ID: 210367
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Slide1
Antenatal Weight Management
Ailsa Millen
Healthy Lifestyle Midwife Slide2
A Big Problem?
One fifth of pregnant women in the UK are obese.
Maternal obesity has become one of the most commonly occurring risk factors in obstetric practice.
Obesity has overtaken smoking as the biggest threat to women during pregnancy.Slide3
The Future
By 2050 it is estimated that 50% of all women will be obese and obesity-related diseases will cost the NHS an extra £45.5 billion per year.
It is increasingly recognised that pregnancy and early years are the intervention opportunities most likely to impact on the obesity epidemic.Slide4
The Deadly facts
Obesity in pregnancy is associated with a higher risk of morbidity and maternal death.
The Confidential enquiry into Maternal and Child Health (2007) found that over half of mothers who died in pregnancy, childbirth or within 42 days of childbirth, were either overweight or obese.Slide5
Risks of obesity during pregnancySlide6
Risks to the infantSlide7
Impact on the NHS
Increased need for specialized equipment
Higher levels of care requirements
Increased costs
Increase in maternal complications
Implications for the infantSlide8
Intrapartum Care
Specialist furniture
Difficulty in gaining venous access
Difficulty in blood pressure monitoring
Difficulty in monitoring the fetal heart
Difficulty in performing vaginal examinations and fetal blood sampling
Increased incidence of failure to progress
Increase in instrumental deliveries and LSCS
Increased risk of shoulder dystocia
Anaesthetic problems
Increased risk of infection, haemorrhage & thrombosisSlide9
Findings locally
1 in 3 of women who book at Lincoln County Hospital have a BMI>30.
Increase in the number of women with BMI>40 and BMI>50.
Asked to carry out an audit in 2009 regarding outcomes of women with BMI 30-40.
Results were shocking!
Slide10
Audit Results
Small sample of 30 women with BMI 30-40 (control group of 30 women with BMI 20-25).
50% (15%) had induction of labour (IOL).
IOL for raised BP 87% (0).
Emergency LSCS 24% (4%).
Normal birth 66% (81%).
Raised BP 64% (4%).
Pre eclampsia 34% (4%).
Slide11
Audit Results Cont’d
Stillbirth 4% (0)
Antenatal haemorrhage 17% (11%).
Post partum haemorrhage 17% (4%).
Difficult to scan/monitor 67% (0).
Premature labour 20% (4%).
Baby >4000g 13% (4%).
Baby <2500g 13% (8%).
Slide12
Weight Management in Pregnancy
Dieting is not recommended!
Excessive weight gain needs to be prevented.
Ensure a nutritionally adequate diet.
Moderate exercise on a regular basis unless contraindicated.
Currently in the UK there are no National Guidelines for weight gain in pregnancy.
We use the USA Institute of Medicine recommendations which state a weight gain of 5-9kg for women with a booking BMI >30.
Slide13
New Service in Lincoln
Bumps & BeyondSlide14
Service in Lincoln BMI>35
Extra A/N appointment with dedicated Consultant at 14 weeks also see Healthy Lifestyle Midwife ensures relevant prescriptions and appointments are organised.
Seen seven times throughout pregnancy at one-one appointments and once post-natally.
Sessions on nutrition, exercise, food labelling, shopping, behaviour change, goals etc.
Pilot in Lincoln, will be rolled out across the county.
Slide15
Any Questions?
Slide16
4-7 Year Old Weight Management Service
Pilot project covering 3 areas: Spalding, Skegness & Coastal and Gainsborough.
Over-riding aim of the programme is to ensure that all children within these areas have a healthy weight by being physically active and eating healthily.
Programme designed by Phoenix Weight Management Team. Slide17
4-7 Year Old Weight Management Service
Slide18
4-7 ‘s – Meet the Family!
Amy the Aubergine
B
roccoli SpearsSlide19
4-7 Year Old Weight Management Service
Chill & Lee Paul the PineappleSlide20
4-7 Year Old Weight Management Service
Sammy StrawberrySlide21
Lincolnshire Obesity Rates 2009/10
School
Year
Weighed
Obese
2009-2010
Overweight
2009-2010
Healthy Weight
2009-2010
Reception
724 children
(10.8%)
(England
9.8%)
1007 children
(15%)
4954 children
(74%)
Year 6
1298 children
(19.5%)
(England
18.7%)
1024 children
(15.5%)
4328 children
(65%)Slide22
4-7 Year Old Weight Management Service
Children identified by NCMP measurements.
Parent and child invited to attend the one year programme consisting of 12 weekly sessions, first and last being on a one to one basis.
Remaining 10 sessions held in groups.
Follow up sessions every 3 months.Slide23
4-7 Year Old Weight Management Service
Different topics each week.
Healthy Eating, food groups, shopping.
Portion size, lunch boxes, snacks.
Being active, reducing amount of ‘screen time’.
Topic based activities for parent and child to take part in.
Interactive sessions.Slide24
4-7’s Activity
In Gainsborough a qualified
fitness
instructor will
facilitate the activities for the children.
They
have already done a lot of work with schools using the framework of ABC (agility, balance and co-ordination) with activities.
Family
vouchers towards roller skating, swimming etc.
Possibility of
some free ‘boot camp’ days for the children in the summer holidays. Slide25
4-7 Year Old Weight Management Service
Very early days!
Watch this space!
Bye for now!!