Clinic weighs in to aid obese mothers to be

SCOTLAND'S first clinic for overweight mothers-to-be is being set up in a bid to cut the death rate among obese pregnant women and their babies.

Patients will be referred to the clinic by midwives and offered advice on diet and lifestyle as well as receiving extra scans and health checks.

Obese mothers account for one third of all pregnancy-related deaths despite making up a quarter of all births. Obese women are more likely to suffer miscarriage, stillbirth and early labour than women whose weight is within the normal healthy range when they are pregnant.

Babies born to obese mothers are more likely to suffer from spina bifida, heart problems and other birth defects as well as being overweight when they are born or later in life, and experts are increasingly worried about the impact of the UK's obesity crisis on the nation's health.

The Metabolic Clinic at Edinburgh Royal Infirmary's Simpson Centre for Reproductive Health will open in February and treat up to 200 women each year who are found to be obese when they visit their midwife for their first pregnancy check at around 10-12 weeks. Midwives will refer women to the service if they have a body mass index of more than 30, for example, a 5ft 4ins tall woman weighing 12 and a half stone.

The clinic has received £400,000 funding from the baby charity Tommy's and a similar amount from Edinburgh University.

The clinic will be run by Andrew Calder, Professor of Obstetrics and Gynaecology and head of reproductive and developmental sciences at Edinburgh University. He said: "There is a lot of interest in obesity but it is not just one single disorder. There are a lot of ramifications.

"Obese women do tend to put on more weight during pregnancy than those who started out as slim.

"They may be offered a sensible eating plan. Diet is a very important subject. It is generally felt that it is not sensible to lose weight while pregnant so it's more about trying to make sure they don't put on too much weight.

"We have got to be very tactful about this because it's very easy for people to feel guilty. But I am not unduly critical of people who are overweight because I can understand how it happens.

"This is not going to give us spectacular results overnight. It's going to be a long haul to get to grips with the real issues."

Usually women see their midwife for antenatal checks every four weeks during pregnancy, and every two weeks as they approach their due date, to check blood pressure, weight, the baby's heartbeat and movements.

Patients at the Metabolic Clinic will attend these regular checks with their own midwife but will also be seen around four times by the specialists at Simpson's for extra checks. These will include scans and checks on the baby as well as checks on the mother such as measurements of their body fat distribution and their waist to hip ratio.

The clinic research team will use the information gained from the patients to monitor the effects of obesity on mothers and babies.

One of the main aims of their research will be to discover exactly why obesity in the mother can cause problems for the baby.

Jonathan Cunnington, director of The Obesity Awareness and Solutions Trust (TOAST), welcomed the initiative.

He said: "This is an important issue and we would support anything that addresses it.

"However if overweight people are encouraged to do something different to those of a healthy weight they might feel upset about that.

"So how it is handled is very important."

Diet advice

Pregnant women are advised to eat healthily from the main food groups: carbohydrates such as bread and pasta; five portions of fruit and vegetables a day; meat, fish and alternative proteins such as eggs, beans and pulses; dairy foods including milk, cheese and yoghurt.

• Foods containing fat and sugar should be kept to a minimum.

• Avoid soft cheeses such as brie, liver, pate, raw and undercooked eggs.

• Eat more foods containing folic acid such as green vegetables, beans, pulses and some fruits including oranges and bananas.