GPs should help obese women to lose weight before and between pregnancies, according to new guidance published by the Royal College of Obstetricians and Gynaecologists.
The RCOG said that obesity can increase the risk of complications for both mother and baby, but these can be minimised with the care and support outlined in the new guidance.
It recommended that women be weighed and offered advice on weight and lifestyle in primary care, such as during pre-conception counselling and appointments about contraception.
GPs could also recommend a structured weight-loss programme and a referral to a dietician or an appropriately trained healthcare professional.
For women unable to lose weight before pregnancy, the guidance recommends comprehensive, sensitive and appropriate multi-disciplinary care, including a consultation to ensure women are informed about the increased risks of complications for her and her baby, and dietetic advice by a trained healthcare professional should be offered early in the pregnancy, based on NICE guidelines.
Complications for women who are obese include higher risk of miscarriage, stillbirth, pre-eclampsia, gestational diabetes and postpartum haemorrhage – the most common cause of maternal death directly related to pregnancy in the UK.
Latest figures for England show around 22% of pregnant women are obese, 28% are overweight and 47% within a normal range.
Dr Daghni Rajasingam, consultant obstetrician and spokesperson for the RCOG, said: ‘Pregnant women who are overweight or obese have increasingly more complex health needs.
‘It is crucial that healthcare services – from primary care to maternity services – offer specialist weight management advice and support for women who are planning a pregnancy and for those women who are pregnant who are planning a pregnancy and for those women who are pregnant.
‘We must ensure maternity services must be well-resourced to manage any pregnancy and birth complications that may arise to ensure the safest possible pregnancy and a healthy baby.’
Previous research has shown that overweight or obese women are at increased risk of poor pregnancy outcomes including congenital abnormalities.
