Sarah R Chwah1, Amanda Reilly2, Beverley Hall3, Anthony J O'Sullivan4, Amanda Henry5. 1. Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia. 2. St George and Sutherland Weight Intervention Group, NSW, Australia. 3. Royal Hospital for Women, Randwick, NSW, Australia. 4. St George and Sutherland Clinical School, NSW, Australia. 5. Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia; School of Women's and Children's Health, UNSW Medicine, University of New South Wales, NSW, Australia.
Abstract
AIMS: To compare pregnancy care, maternal and neonatal outcomes of women with Body Mass Index (BMI) >30 enrolled in a Weight Intervention Group versus other models of antenatal care. METHODS: Retrospective, case-control study of mothers with BMI >30 managed with a specialised programme versus age-matched women enrolled in standard models of care. RESULTS: One thousand, one hundred and fifteen of 9954 pregnant women with singleton pregnancies, had a BMI >30, of whom 9.6% enrolled in the intervention group. Compared to controls, the intervention group had superior implementation of local high BMI guidelines, including; nutritional /weight gain advice (86% vs. 46%, p < 0.001), regular weighing (80% vs. 33%, p < 0.001), lactation consultant referrals (8% vs. 1%, p = 0.02), third trimester anaesthetic review and ultrasound (50% vs. 20.9%, p = 0.04 and 55% vs. 43%). Initiation of breastfeeding was higher in the intervention group (100% vs. 90%, p = 0.001). No significant difference was noted in Caesarean rate (30% vs 32%) and birthweight (3538 g vs 3560 g). CONCLUSIONS: Women with high BMI enrolled in a specialised antenatal management programme received increased care, and had superior breastfeeding initiation rates. However, engagement was poor, and no significant differences were noted in antenatal or postnatal complications, mode of birth or neonatal outcome.
AIMS: To compare pregnancy care, maternal and neonatal outcomes of women with Body Mass Index (BMI) >30 enrolled in a Weight Intervention Group versus other models of antenatal care. METHODS: Retrospective, case-control study of mothers with BMI >30 managed with a specialised programme versus age-matched women enrolled in standard models of care. RESULTS: One thousand, one hundred and fifteen of 9954 pregnant women with singleton pregnancies, had a BMI >30, of whom 9.6% enrolled in the intervention group. Compared to controls, the intervention group had superior implementation of local high BMI guidelines, including; nutritional /weight gain advice (86% vs. 46%, p < 0.001), regular weighing (80% vs. 33%, p < 0.001), lactation consultant referrals (8% vs. 1%, p = 0.02), third trimester anaesthetic review and ultrasound (50% vs. 20.9%, p = 0.04 and 55% vs. 43%). Initiation of breastfeeding was higher in the intervention group (100% vs. 90%, p = 0.001). No significant difference was noted in Caesarean rate (30% vs 32%) and birthweight (3538 g vs 3560 g). CONCLUSIONS:Women with high BMI enrolled in a specialised antenatal management programme received increased care, and had superior breastfeeding initiation rates. However, engagement was poor, and no significant differences were noted in antenatal or postnatal complications, mode of birth or neonatal outcome.
Authors: Ingrid Rowlands; Nick Graves; Susan de Jersey; H David McIntyre; Leonie Callaway Journal: Semin Fetal Neonatal Med Date: 2009-10-12 Impact factor: 3.926