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Breaking the cycle

There is an urgent need to provide better strategies for maternal obesity, writes Annie May.

Maternal obesity is the most common factor in high-risk pregnancies. Yet, in Australia there is little done to reduce this risk.

This is becoming increasingly concerning to health experts, particularly after a study that found very few women achieved the recommended food group servings for pregnancy, and more than half (52 per cent) gained excess weight during pregnancy.

The Brisbane researchers surveyed 50 overweight and obese pregnant women on their dietary intake and weight gain during and shortly-after pregnancy. The women were aged 18 to 45 years.

Only 10 per cent of participants achieved the recommendations for vegetables, and just one in four (26 per cent) ate enough fruit.

None of the women met the recommendation for dietary iron, only 11 per cent took in enough dietary folate, a nutrient needed to help prevent neural tube defects in babies, and just 38 per cent ate enough calcium. There was little change in kilojoule intakes through the pregnancy and no improvement in fat intake.

Susan de Jersey, co-author of the study said the results further proved the need to target overweight and obese women with early education and support to achieve appropriate weight gain and good nutrition during pregnancy.

“Maternal obesity is the most common factor in ‘high risk’ pregnancies, with more than one-third of all pregnancies complicated by maternal overweight and obesity,” says de Jersey, a practising dietitian.

“Less than one in five participants in our study recalled being spoken to by a health professional about their optimal weight gain during pregnancy,” she says.

She says providing personal weight gain goals and more targeted, individual dietary advice could lead to more appropriate weight gain in women during pregnancy.

As well as reducing risk during pregnancy, targeting obese and overweight expectant mothers is a preventative measure and will help “break the cycle.”

“Babies born to overweight mothers tend to be overweight. Yet targeting these women during pregnancy isn’t well recognised in Australia as a preventative measure,” says de Jersey.

“Pregnancy provides a window of opportunity to impact on the health of future generations at a time when women and their families are in contact with health services and may be more motivated to improve their lifestyle.”

The study has identified specific challenges for obese women that require targeted and individualised support in order to meet the current dietary recommendations.

“Nutrition intake is reasonably standard, but weight gain goals should be individualised. Early intervention and personalised support for obese pregnant women may help achieve individualised goals for maternal weight gain and dietary adequacy, but these need to be tested in a clinical setting.

“Dietitians need to be part of the antenatal team, and if that can’t happen other health workers had to be trained in advising these women.”

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