Madeleine C Ward1, Anju Agarwal2, Melanie Bish3, Rachel James2, Fiona Faulks2,3, Jennifer Pitson2, Nicola Yuen2, George Mnatzaganian4. 1. Department of Obstetrics and Gynaecology, Monash Health, Melbourne, Victoria, Australia. 2. Department of Women's & Children's Services, Bendigo Health, Bendigo, Victoria, Australia. 3. Department of Rural Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia. 4. Department of Community and Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
Abstract
AIMS: Obesity-related complications have been identified across the entire childbearing journey. This study investigated changes in obesity prevalence and their impact on obstetric outcomes in a regional hospital in Victoria, Australia. METHODS: All women delivering during 1 January 2010 and 31 December 2016 were eligible to participate. Trends over time and outcomes were assessed on body mass indices (BMI). Incidences of complications were compared by BMI categories. The effect of obesity on hospital length of stay (LoS) was further assessed using the Generalised Estimating Equations approach. RESULTS: During the study period a total of 6661 women of whom 27.5% were overweight, and 16.1, 7.7, and 5.5% were respectively obese class I, class II, and class III, contributed to 8838 births. An increased trend over time in the prevalence of obesity (BMI > 35.0) (P = 0.041) and a decreased trend for vaginal deliveries for the whole sample (P = 0.003) were found. Multiple adverse outcomes were associated with increasing maternal BMI including increased risk of gestational diabetes, gestational hypertension, preeclampsia, emergency caesarean section, shoulder dystocia, macrosomia, and admission to special care. The multivariable analysis showed no associations between LoS and BMI. CONCLUSIONS: Over a short period of seven years, this study provides evidence of a significant trend toward more obesity and fewer vaginal births in a non-urban childbearing population, with increasing trends of poorer health outcomes. Assessing needs and risk factors tailored to this population is crucial to ensuring a model of care that safeguards a sustainable and effective regional maternity health service.
AIMS: Obesity-related complications have been identified across the entire childbearing journey. This study investigated changes in obesity prevalence and their impact on obstetric outcomes in a regional hospital in Victoria, Australia. METHODS: All women delivering during 1 January 2010 and 31 December 2016 were eligible to participate. Trends over time and outcomes were assessed on body mass indices (BMI). Incidences of complications were compared by BMI categories. The effect of obesity on hospital length of stay (LoS) was further assessed using the Generalised Estimating Equations approach. RESULTS: During the study period a total of 6661 women of whom 27.5% were overweight, and 16.1, 7.7, and 5.5% were respectively obese class I, class II, and class III, contributed to 8838 births. An increased trend over time in the prevalence of obesity (BMI > 35.0) (P = 0.041) and a decreased trend for vaginal deliveries for the whole sample (P = 0.003) were found. Multiple adverse outcomes were associated with increasing maternal BMI including increased risk of gestational diabetes, gestational hypertension, preeclampsia, emergency caesarean section, shoulder dystocia, macrosomia, and admission to special care. The multivariable analysis showed no associations between LoS and BMI. CONCLUSIONS: Over a short period of seven years, this study provides evidence of a significant trend toward more obesity and fewer vaginal births in a non-urban childbearing population, with increasing trends of poorer health outcomes. Assessing needs and risk factors tailored to this population is crucial to ensuring a model of care that safeguards a sustainable and effective regional maternity health service.
Authors: Mia Shepherdson; Shalem Leemaqz; Gurmeet Singh; Courtney Ryder; Shahid Ullah; Karla Canuto; Joanne P Young; Timothy J Price; Ross A McKinnon; Stephen J Pandol; Claire T Roberts; Savio George Barreto Journal: Cancers (Basel) Date: 2022-06-10 Impact factor: 6.575
Authors: Melanie Rae Bish; Fiona Faulks; Lisa Helen Amir; Rachel R Huxley; Harold David McIntyre; Rachel James; George Mnatzaganian Journal: BMJ Open Date: 2021-02-10 Impact factor: 2.692
Authors: George Mnatzaganian; Mark Woodward; H David McIntyre; Liangkun Ma; Nicola Yuen; Fan He; Helen Nightingale; Tingting Xu; Rachel R Huxley Journal: BMC Pregnancy Childbirth Date: 2022-02-01 Impact factor: 3.007