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Maternal weight and the obesogenic environment in Nova Scotia

Maternal weight and the obesogenic environment in Nova Scotia. Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney. “…today’s principal neglected public health problem...” (WHO, 1997)

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Maternal weight and the obesogenic environment in Nova Scotia

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  1. Maternal weight and the obesogenic environment in Nova Scotia Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney

  2. “…today’s principal neglected public health problem...”(WHO, 1997) “…one of the most important medical and public health problems of our time..."(Prof. Philip James, IOTF Chairman) “…given the prevalence of childhood obesity, and given its contribution to many diseases, this is the first generation that may not live as long as their parents…”(Dr. Kellie Leitch) The obesity time bomb

  3. Obesity rates, by province and sex, 2004

  4. Overweight and obesity rates: children and youth, by province, 2004

  5. So, what happened? www.foresight.gov.uk

  6. Obese mothers are at a high risk for many complications Children with obese parents are themselves more likely to be obese as adults Supportive programming for mothers is key to obesity prevention Pregnancy and post-partum: an ideal time for intervention

  7. The pregnant population in Canada • No national surveillance system that routinely measures pregnancy weight in Canada • Canadian Perinatal Surveillance system (CPSS) collects 27 health outcomes but not BMI of the mother

  8. The Atlee Perinatal Database • Provincial level population-based, computerized database with information on pregnancy outcomes • Maternal/newborn data available for every pregnancy of > 20 weeks gestation, with a birth weight of 500g or more • Data on self-reported pre-pregnancy weights from 1988

  9. To describe the temporal, socio-economic and demographic trends in normal weight and obese pregnant women in Nova Scotia Part of a larger study investigating the influence of the obesogenic environment on maternal body weight Objective

  10. Methods • Self-reported pre-pregnancy weights on women in NS (1988-2006) • 172,373 deliveries (2108 multiple births) • normal weight = 55-75 kg • moderately obese = 90-120 kg • severely obese > 120 kg • Analyses to look at trends in maternal body weight by: • Time • Age • Parity • SES • Urban/rural

  11. Subject characteristics

  12. Variation in maternal bodyweight over time, 1988-2006 8.6 kg increase 72.0 70.0 mean 68.0 median 66.0 64.0 Bodyweight (kg) 62.0 60.0 58.0 56.0 54.0 52.0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Year

  13. Number of deliveries to women with pre-pregnancy weight >120kg

  14. Maternal obesity: A provincial problem

  15. Summary of results • Obese women: • were slightly older • were of lower SES • gained less weight during pregnancy • were more likely to live in rural areas

  16. Maternal weights have increased dramatically over the last 20 years in Nova Scotia • Deliveries in severely obese women have more than tripled since 1988 • These trends have implications for population health and health care delivery • Maternal and child health • Staffing • Resources Conclusions

  17. In-depth exploration of the influence of the obesogenic environment on maternal body weight • Investigation of maternal obesity in the context of the child • Recommendations for family-centred management and prevention What next?

  18. IWK Health Centre funding (Tarra Penney and Trevor Dummer) • Reproductive Care Program of Nova Scotia (data access) Acknowledgements

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