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Healthy Weight in Pregnancy

Merryn Anderson. Healthy Weight in Pregnancy. Summary. Why healthy weight in pregnancy is important The situation nationally and in Cornwall Moving forward. Healthy weight in pregnancy. Reduce fertility 1 Risk for mother and foetus during pregnancy 2 Risk of illness in later life 3

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Healthy Weight in Pregnancy

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  1. Merryn Anderson Healthy Weight in Pregnancy

  2. Summary • Why healthy weight in pregnancy is important • The situation nationally and in Cornwall • Moving forward

  3. Healthy weight in pregnancy • Reduce fertility1 • Risk for mother and foetus during pregnancy2 • Risk of illness in later life3 • NICE guidelines4

  4. Nationally

  5. Women aged 16-446

  6. Cornwall

  7. Moving forward • Pre-pregnancy • Pregnancy • Post-natal

  8. Pre-pregnancy Everyone presenting to primary care with BMI >25 People presenting with subfertility and BMI > 29.9 Adult Obesity pathway

  9. Pregnancy-booking clinic All women at booking clinic • Consents women • Highlights relevant diet and exercise chapters in ‘The Pregnancy Book’ • Signposts Healthy Lifestyle in Pregnancy service and children’s centres

  10. Pregnancy – 12 week scan All women to have an accurate BMI recorded at the 12 week scan BMI >30 BMI <30 Midwife to give ‘Obesity in Pregnancy’ leaflet • Universal advice • Signpost to website • Give option for self referral to Healthy Lifestyle in Pregnancy • If not opted out contacted by specialist midwife with the Healthy Lifestyle in Pregnancy to receive individualised plan • Behaviour change advice • Healthy eating/exercise • Information about services available • Create personal goals and agree follow up plan • Invitation to Obesity in Pregnancy Group • If BMI >40 to be seen by specialist as part of the anaesthetic review clinic Follow up phone-call, text, internet as agreed in individual plan

  11. Post-natal Based on BMI recorded at the 12 week scan BMI >30 BMI <30 Midwife to review progress and give individualised information on: • Exercise advice (RCOG guidelines) • Behaviour change advice • Healthy living pack/website access • Breast feeding • If BMI >35 options to include invitation to weight matters course • Slimming world/weight watchers • Universal advice • Signpost to website Follow up at 3 and 6 months post-natal

  12. Summary • Why healthy weight in pregnancy is important • The situation nationally and in Cornwall • Moving forward

  13. Any suggestions?Anyquestions?

  14. References • Jan Willem van der Steeg; PieternelSteures; Marinus J.C. Eijkemans; J. Dik F. Habbema; Peter G.A. Hompes; Jan M. Burggraaff; G. Jur E. Oosterhuis; Patrick M.M. Bossuyt; Fulco van der Veen; Ben W.J. Mol. Obesity Affects Spontaneous Pregnancy Chances in Subfertile, Ovulatory Women. Human Reproduction. 2007;Vol 23:324-328 • Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011;118 (Suppl. 1):1–203. • Department of Health: Obesity 2011. Available from http://www.dh.gov.uk/health/category/policy-areas/public-health/obesity-healthy-living/ [Accessed 23/4/12]

  15. Weight management before, during and after pregnancy: Dietary interventions and physical activity interventions for weight management before, during and after pregnancy. National Institute of Clinical Excellence 2010. Available from http://guidance.nice.org.uk/PHG/Wave18/3 [Accessed 23/4/12] • Centre for Maternal and Child Enquiries (CMACE). Maternal obesity in the UK:Findings from a national project. London: CMACE, 2010 • The Health and Social Care Information Centre. The health survey for England 2007: latest trends. London: The Health and Social Care Information Centre; 2008

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