Weight management before, during and after pregnancy (CMG36) – NICE – March 2011

Posted on April 19, 2011. Filed under: Obstetrics | Tags: , |

Weight management before, during and after pregnancy (CMG36) – NICE – March 2011

“The Confidential Enquiry into Maternal and Child Health (CEMACH) (2007) highlighted that obesity in pregnancy carries significant risks and identified that over half the women who died either directly or indirectly from pregnancy related causes were overweight or obese[1]. Babies born to obese women also face several health risks including a higher risk of fetal death, stillbirth, congenital abnormality, shoulder dystocia, macrosomia and subsequent obesity[2].

The resulting NHS costs attributable to being overweight and obese are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year[3]. The NICE costing report for NICE public health guidance PH27 highlights that additional costs are incurred when complications arise in pregnancy, during delivery and following childbirth. Increased risks of complications during pregnancy and after childbirth include impaired glucose tolerance and gestational diabetes, miscarriage, pre-eclampsia, thromboembolism and maternal death[4].

Weight management includes assessing and monitoring body weight, preventing someone from becoming overweight (body mass index [BMI] 25–29.9 kg/m2) or obese (BMI greater than or equal to 30 kg/m2), and helping them to achieve and maintain a healthy weight before, during and after pregnancy by eating healthily and being physically active and gradually losing weight after the baby is born. NICE public health guidance PH27 recommends that pregnant women have their weight and height measured and BMI calculated and recorded at the first contact with the health professional. This is important because obesity will have a greater influence on the pregnant woman’s health and the health of her unborn child than the amount of weight she may gain during pregnancy. Calculating and recording BMI will help with care planning and with the aim of preventing or managing any complications related to obesity. It is also important to commission weight management services to help women lose weight before they become pregnant.”

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