What is the current prevalence of extreme obesity in pregnancy in the UK?
What is the prevalence among different racial and socioeconomic groups?
What are the risks of adverse outcomes for mother and infant associated with extreme obesity in pregnancy?
Are any adverse outcomes associated with inadequate weight capacity equipment?
Obesity is now recognised to be an important public health problem throughout the developed world. The prevalence of obesity is rising rapidly in the UK in all age groups, including women of reproductive age. Recent reports of the UK Confidential Enquiry into Maternal Deathshave highlighted obesity as a factor in increasing numbers of maternal deaths in the UK. Retrospective database analyses in Canada, Australia and the UK have identified particular disease risks associated with pregnancy among obese women, including pre-eclampsia, venous thromboembolism and gestational diabetes, and higher rates of labour induction, delivery by caesarean section, general anaesthesia and anaesthetic complications. Obese women are also at increased risk of poor perinatal outcomes, including stillbirth and neonatal death. The majority of these studies focus on women with moderate obesity (BMI greater than 30). The studies therefore include only a very few women who are extremely obese and have not specifically addressed the risks in the extremely obese group. The risk of pregnancy complications in extremely obese women is potentially even higher than among moderately obese women. However, because of the relatively small numbers of women with this degree of obesity, a national study is needed to investigate this further.
All women in the UK identified as having:
EITHER any woman weighing over 140Kg at any point during pregnancy
OR any woman with a Body Mass Index (BMI) greater than 50 at any point during pregnancy
OR any woman estimated to be in either of the previous categories but whose weight exceeds the capacity of hospital scales.
Extrapolation from the Millennium Cohort Study suggests the study may expect to identify 200-300 cases over a one year period (based on 9 extremely obese women in a cohort of 18,000).