Obesity epidemic blamed for rise in dangerous births
SCOTLAND’S obesity epidemic and the rise in older mothers has seen the number of serious complications in childbirth double.
Experts say the healthcare needs of pregnant women are becoming more complex because of a rise in severe ‘maternal morbidity’ – illness or other medical problems in expectant mothers.
These are linked to factors including obesity, women giving birth at a more advanced age and an increase in the caesarean rate.
The findings have come in a study of pregnancies in Scotland over 14 years. It found the rate of severe complications such as sepsis and haemorrhage in childbirth doubled to 1.7 per cent of pregnancies between 2012 and 2018.
The Edinburgh University researchers said: ‘The reality is that the increasing complexity of healthcare needs of women during pregnancy means that they need greater levels of care during pregnancy and delivery.’
The study looked at 762,918 pregnancies, of which 7,947 (one in 100) fell into a category constituting a severe complication, with the most common being maternal sepsis, a severe infection of the womb that can happen after a caesarean. Other severe complications included stroke, haemorrhage, uterine rupture and cardiac problems.
The risk of severe maternal morbidity was higher for older women, with those aged 40 and over 44 per
more likely and those 35-39 years 22 per cent more likely than those aged 25-29 to experience it.
Severely obese women were 32 per cent more likely to suffer than women with a normal body mass index (BMI), while slightly obese women were 13 per cent more likely. Women bearing multiple children also faced a higher risk of complications than those with single babies (2.4 per cent), while women with pre-existing health conditions were four times more likely than women with none.
Those who had given birth through a caesarean were 52 per cent more likely to experience problems than those who had not had the operation.
Severe maternal morbidity incidence increased from nine in 1,000 pregnancies in 2012 to 17 in 1,000 pregnancies in 2018.
Led by Dr Nazire Lone of the University of Edinburgh, the authors said: ‘The increasing prevalence of these factors in UK mothers might stall historical reductions in maternal mortality and will increase the need for healthcare during pregnancy and childbirth.’
Those mothers experiencing severe complications were more likely to have longer hospital stays, more stillbirths and be more likely to lose their life than mothers without.
The findings, published in the journal Anaesthesia, show that across all pregnant women combined, the death rate was 5.4 per 100,000 pregnancies. The authors concluded: ‘Severe maternal morbidity accompanied ten in 1,000 pregnancies in Scotland.’
In 2021, one quarter of the pregnant women in Scotland were obese by the time they booked an antenatal appointment.
‘Greater levels of care needed’