PREGNANT WOMEN who are obese run a two- to three-fold risk of delivery by emergency Caesarean section, a new study by medical experts in Galway has found.
The incidence of pregnant women who are overweight or obese has also increased, with consequent health implications for both mother and child, according to the study at University College Hospital, Galway (UCHG).
The research, by Prof John Morrison and Dr Caoimhe Lynch of NUI Galway's department of obstetrics and gynaecology, is the first of its type in Ireland. Its findings have been published in the American Journal of Perinatology.
The study on the effects of maternal body mass index (BMI) took a sample of 5,162 women who delivered between 2001 and 2002 at UCHG. The BMI data was measured and compared with the delivery that the women experienced - as in, normal vaginal delivery, assisted normal vaginal delivery (forceps or vacuum) and emergency Caesarean section.
Of the grouping, some 2,006 were first-time mothers, while 3,156 were on a second or subsequent birth.
The BMI statistics found that some 2.6 per cent of women in the group were underweight, 49.2 per cent were of normal weight, 22.8 per cent were overweight, 19.8 per cent were obese and 5.6 per cent were morbidly obese.
Normal weight is classified as between 60kg and 70kg for women of average height (five foot four), while 70-80kg is overweight, 80-100kg is obese and over 100kg is morbidly obese.
Prof Morrison said that while there was a general awareness that obesity levels had risen in Ireland, the researchers were shocked to discover the high percentages of overweight and obese pregnant women.
Adverse health implications included a higher risk of infertility, miscarriage, menstrual disturbance, Caesarean section and clots. "These levels are significantly high when compared with international literature," Prof Morrison said.
The study then investigated the delivery outcome for women who were obese and compared it with that of women of normal weight.
For women in their first pregnancy who were of normal weight, the normal delivery rate was 83.1 per cent, but fell to 55.3 per cent for obese women.
The authors believe that obese women in their first pregnancy should be "clearly counselled" about the 30 per cent risk of emergency Caesarean section in delivering their baby.
Most of the data currently available on the topic applies to US populations, with only two British studies relating to it. Prof Morrison said that the findings had major implications for healthcare in Ireland.
Speaking to The Irish Times, Prof Morrison said that the practice of weighing women every time they went for a check-up during pregnancy had waned due to the development of other methods for examining the health of both the mother and the child.
He believed there should be a much greater level of awareness about the importance of maintaining a healthy weight from early on in pregnancy. "There's no point talking about it when the pregnancy is advanced," he observed.