OBESE pregnant women in Scotland have been provided with specialist health trainers, exercise DVDs and handed a strict diet to follow in a Government-funded initiative out to slash the country’s soaring rates of maternal diabetes.
Around one in five pregnant women is overweight or obese in Scotland, putting them at risk of almost every pregnancy complication, including pregnancy-induced gestational diabetes, which affects around one in 20 Scottish pregnancies.
Diabetes increases a mother’s risk of a host of other problems, including miscarriage and stillbirth, as well as having a baby born too large for its gestational age.
Large birth-weight babies – newborns over 10lbs – are also at increased risk of stillbirth, getting stuck during delivery, and having a lifetime of health complications, including heart disease and diabetes.
More than 1,500 participants – a fifth of those in Scotland – have taken part in the UK-wide Upbeat intervention plan which health professionals hope could change the way maternity care is provided in the country. Participants were given eight sessions with an expert health trainer, an exercise DVD, pedometer, and logbook for recording their health goals and asked to fill out a “binge eating” questionnaire. They also followed a low GI (glycemic index) diet.
Researchers are aiming to reduce the number of women diagnosed with pregnancy-induced diabetes by a quarter and overweight newborn babies by 30 per cent by staging this complex intervention.
Multiple complications can be associated with obesityProfessor Naveed Sattar
The report says: “Obesity reduces fertility, and in pregnancy is associated with a heightened risk of gestational diabetes, hypertensive disorders of pregnancy including pre-eclampsia, and failure to progress in labour. Caesarean section rates are high, and infants of obese mothers are at greater risk of congenital malformation.
“The primary aim of this randomised controlled trial is to assess in obese pregnant women, whether a complex behavioural intervention, based on changing diet (to foods with a lower glycemic index) and physical activity, will reduce the risk of gestational diabetes and delivery of a large for gestational age infant.
“A secondary aim is to determine whether the intervention lowers the longterm risk of obesity in the offspring.”
Researchers say the study will inform guidelines on the management of obesity in pregnancy, and if successful, is designed to be rapidly transferable to clinical practice.
In Scotland, pregnant women are only routinely weighed on their first appointment and offered advice on healthy eating. Health professionals say this may not be not enough.
Professor Naveed Sattar, clinician and professor of metabolic medicine at Glasgow University, led the Scots trial.
He said: “Currently there are specialist clinics in Scotland for women who are very obese in their pregnancy, with a BMI of over 35, and in some cases as high as 40 and over. The Upbeat trial is very important as it is the biggest study on obesity with women with a BMI over 30 in the world.
“We know there is a great amount of evidence that there can be multiple complications associated with obesity in pregnancy and we have been looking at whether lifestyle interventions can help.
“We are looking at whether it is possible to make women change behaviour – does that lower their weight and does that lower the risk of diabetes and then the birth weight of their baby? The results will be looked at by the relevant authorities that write the guidelines for maternity care.”
A spokeswoman for the Scottish Government last night said: “Trials such as this one, supported by the Chief Scientist Office, examine measures for ensuring healthy mums and babies. Through our ten-year Improving Maternal and Infant Nutrition plan we aim to better the diet and nutrition of mothers before conception and during pregnancy.”