P266 Respiratory, sleepiness and metabolic measures and obstetric outcomes in obese expectant mothers
Increasing obesity in the UK population includes expectant mothers.1 Data from local antenatal clinics(3391 deliveries and 3826 women booked in 2011) show that the number of women with a BMI> 30 (O) and BMI>50 (SO) are rising particularly in the last 5 years (Fig. 1). We wished to determine the respiratory consequences and maternal outcome for these women.
We examined obese women with a BMI >50 Kg/m2 (SO) who gave birth in 2011 and matched them against non-obese (BMI <30) women (N) who delivered on the same day. The percentage of SO v N women respectively who gave a history of asthma, diabetes and depression, was 67% v 17%, 50% v 0% and 50% v 17% respectively.
Mean Oxygen saturation in (O and SO) women, supine at rest and awake was 98% and in N 99%. This difference was statistically significant (p = 0.016, unpaired t test, 26 df). Snoring was seen in 67% (O & SO) v 40% N (p = 0.07, χ2). No difference was seen in the mean Epworth sleepiness scores (ESS; 0 6.2 v N 6.6) suggesting ESS is insensitive in these patients. Mean (range) heart rate at rest awake was 84.7 (72–106) bpm in SO and O, v 81.5 (70–99) in N (p= 0.66, unpaired t test)
Mean (range) weight gain during pregnancy in N was 10 (1–16)Kg v 6.3 (–5 – 20) Kg in SO and O (p=0.17, unpaired t test). 100% N but only 67% SO women delivered babies with an acceptable birth weight defined as 2.7–4.0Kg. 37.5% of O and SO women had miscarriages v 8.3% N (p=0.066, χ2).
We conclude that obesity, particularly in SO, is associated with an increasing burden on the respiratory and psychological health of expectant mothers, on the outcome of their pregnancies and hospital services.
Reference Heslehurst N, Ells LJ, Simpson H, Batterham A, Wilkinson J, Summerbell CD (2007)Trends in Maternal Obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. BJOG 114:187–94.
We acknowledge support of Consultant obstetricians, anaesthetists and Midwifery staff.