Obese mothers blamed for baby deaths

[Demi]

The Times
London, UK
Published: 28 February, 2007


Obese mothers blamed for baby deaths

More newborn babies die in Britain than anywhere else in Western Europe, with maternal obesity a significant factor, according to research.

Tommy’s, the charity that sponsors research into miscarriage and premature birth, said that data gathered across the EU suggested that Britain had similar rates of neonatal mortality to Estonia and Hungary. All other Western European countries perform better.

There are 5.1 deaths per thousand babies in Britain, compared with 3.1 per thousand in Sweden. Premature birth is the single biggest cause of death among babies, with about 1,300 dying each year because they were born too soon. This compares with about 930 per year dying of congenital abnormalities, 350 from infection and 241 from cot death.

Professor Lucilla Poston, head of maternal and foetal research at St Thomas’ Hospital, London, who compiled the research on behalf of Tommy’s, said that with obesity rates rising in Britain, the problem of premature births looked set to increase. “British women are the fattest in Europe. People think overweight women give birth to big babies, but actually they are far more prone to pre-eclampsia, which means premature, underweight babies,” she said. “Obesity, added to the growing number of IVF multiple births, means that the problem of premature birth is likely to get worse.”

Twins and triplets account for about one quarter of premature births each year. However, research carried out at St Thomas’ has discovered the existence of a molecule that is responsible for triggering early labour in multiple births, raising hopes that treatment will soon be available to prevent it. Meanwhile, Professor Poston will present research next month calling for an end to a technique commonly used to try to prevent premature birth, known as a “cervical stitch”.

Women who have an “incompetent”, or long, cervix diagnosed by ultrasound scans are routinely treated with a stitch to shorten it.

She said that her research had found no link between this treatment and staving off premature birth.


http://www.timesonline.co.uk/tol/news/uk/health/article1449761.ece

[tripletmom]

Alright... I'm obese, utilized IVF, suffered from pre-eclampsia, incompetant cervix, and had a cerclage (cervical stitch) placed when I was 22 weeks pregnant. I gave birth to premature triplets (32.2 weeks) who were 3.8 lb, 3.15 lb, and 3.16 lb.

They came home after 2 weeks in the hospital, and will be turning 7 years old in a few days.

The only thing that didn't apply directly to me in that article, is that I don't live in Britian... but my husband was born and raised there. Does that count?

My boys, despite being born prematurely, are exceptionally healthy. They were very well taken care of in the NICU when they were born, and followed closely by their pediatricians, and by the hospital at which they were born. We routinely did hearing, vision and developmental screenings. One of my boys is "average" size for his age. The other two are at about 125% for height/weight. We expect these boys to be over 6'3" tall. All of them are ahead of their classmates in reading, math and science. They are all excelling, and one of them is exceptional, and working on a different grade level. They are sweet, well adjusted boys.

BTW... that "cervical stitch" that I had done? SAVED my pregnancy! I would have certainly given birth within days if I hadn't had this "rescue cerclage", which would have resulted in their deaths... 22 week babies have a very low/no chance of survival.

Many mothers of multiples have cerclage procedures done... ALL of them will tell you that it saved their pregnancies.

I'm not sure what research Professor Poston has done, but perhaps she needs to get herself a "rectal stitch" since she obviously has her head lodged firmly up there!

Molecule for early labor? I'd be very interested in hearing more about it... but it sounds suspect to me.

I think today, I'm glad I don't live anywhere NEAR St. Thomas' Hospital in London.

[Fialka]

Yeah, that's a really strange article.

Pre-eclampsia affects, I think, 8-10% of women and they can't yet predict who will have it. Obesity is a risk factor but so is being a first time mom or having PCOS. And you usually don't get it again, every pregnancy is different.

So if you're overweight and get it one time, but not the next, is obesity still to blame?

I'm not convinced that obesity is the causitive factor for premature birth.
Obesity is just going to get blamed for everything because it's become rampant ergo it must be to blame for everything, right? Just because something is large (on many levels) doesn't mean it's the root of all evil.

How often have we found that the obvious solution/culprit is not the right one?

Many times.

And the US fetal death rate isn't much better than the UK's. As far as I can tell, prenatal care in the US sucks. OBs don't want to see you until the end of the first trimester, how is that prenatal care? And you have to lose three babies before they'll do any testing. Yeah, 50% or so of miscarriages are due to genetic abnormalities, but the other 50% aren't and could be treated and save the baby. (That's 500,000 babies a year by the way) Most docs won't look for incompetent cervix unless you've already lost a baby.

Seems like we only bother with preventative care after a baby dies.

F

[PlayDoh]

i see the problem as corner cutting and misinformation. there had been a big deal made because new mothers were being sent home too early and laws were changed to prevent this.

between that and my story, this is why i think it is corner cutting and the babies are suffering for it. where is the accounting for that?

*warning, pregnancy story ahead*

i had bleeding in the first trimester, 12th week, and so we made a middle of the night field trip to the emergency room, panicked of course, and there they were all sneery because this is a common occurance and apparently no big deal. being well read in preparation, at no time did we come across or were we offered this information. i had to be at a cattle herd paper filling meeting the next day, required, and even after that incident, iand having been in the er all night, it was required that i be there. apparently women on their third and fourth children were required to be there as well. it was a recap of all i learned in high school and i much resented being cattle herded in such a manner for something so stupid.

it gets better

i was past due and went for an appointment on a thursday. the baby was in distress. i was sent to the hospital for monitoring for two hours and we were told all was well and i was sent home. i was in arrested labor from thursday afternoon until sunday evening, had a c section on monday morning. my poor son had a fairly bad case of merconium aspiration, something that was never mentioned about being past due or him having been in distress. my labor never did progress and he was in distress for four days at least.

it gets better

over that long weekend, we had called two different hospitals a total of 17 times because we thought it was obvious i was in labor. i had the pain, it was getting shorter...

we were told a variety of things, here are a few

oh honey, this could go on for two more weeks (already overdue hello?)

go take a warm bath

you could come in, but if you aren't dialated 4, we'll send you home

fortunately, all is well, my son is 5 and a half, and although he had a poor start, he's good to go now, but still, can you see the trend here? we felt like something was wrong, but were told by the pros over and over that everything was fine and we went with that, being new and unsure. never again. also interesting to note, never i our reading or from any health professional did we ever hear or come across the term merconium aspiration, and yet, well over half of the babies in the nicu were there with some degree of merconium aspiration.

kaiser at it's finest

it gets better

i had a yard sale over the summer, last summer, and a lady in her last month of pregnancy stopped by to see if i had any baby clothes. we got to chatting and i found out she had kaiser. i told her my story and also said, whatever you do, don't let them send you home if you think you are in labor.

fast forward a couple of weeks

kindergarten has started and her little girl is in my son's kindergarten class. she's had her baby and i take a peek, she starts telling me what happened.

she had an appointment because she had been leaking and was concerned and she thought her labor had started, she got sent home and told that we ladies have a tendancy to sweat.. she went home, her labor progressed, she called 911, the two emergency vehicles collided outside her house, and while they were outside filling out incident reports, a neighbor helped deliver her baby in the entrance hall of her house and the baby was born with the amniotic sack stuck to her face because it was amniotic fluid she had been leaking, and the cord wrapped twice around her neck. thankfully she is all right. she's almost 6 months old and progressing beautifully. how ironic that we should meet, have such a discussion, and yet it happens again. the stories are so common as to be totally disgusting. her and i are friends now and walk our little guys to school together most days, but we met as strangers over a common insurance carrier. sometimes i look at my son and her daughter and just marvel at how lucky we both were, but i still get so angry at the cattle herding techniques, corners cut, and cavalier attitudes or just plain attitudes that put our babies in such danger. i don't expect doctors and nurses to know everything, but it makes a big difference just to be treated as people, and a bigger difference still when one remembers that one is charged with handling a small person with a fragile life, not a case, not a statistic, and not group.

i would expect reasonable limitations with insurance coverage and for there to be procedures to follow, but from experience, it seems to me that the doctors and nurses are extremely limited in their bounderies in some of the hmo programs for instance, having to visit 6 doctors in order to be able to get a common prescription because my husband's doctor was out of town, and be accused of doctor shopping to boot.

sorry to sound ranty, and yet i'm not. i truly feel that all this corner cutting and cattle herding puts our babies in danger more than anything else, and it's silly really, because just those two incidents of emergency care caused their foundation alot more money than a little better prenatal care, information, and human contact would have.

[tripletmom]

While I'm at it....

This article was MUCH more about pre-mature births, multiples, and "cervical stitch" procedures. They mentioned obesity precisely twice, one stating that obesity could be a factor in premature birth, and the other stated that with rising obesity rates, that "the problem of premature births looked set to increase". It doesn't say it WILL increase, it says it MAY.

So why on GOD'S GREEN EARTH does the title of this article state:

"Obese mothers blamed for baby deaths"

I honestly thought it was going to be an article about co-bedding, and that obese moms are rolling over on their babies and smothering them!

I suppose it could also point to obese mother's EATING their babies, because they can't control their food intake? (no offense meant here... just being dramatically sarcastic)

I truly felt that I was well taken care of in my pregnancy... HOWEVER... I did IVF/ICSI (and I also have PCOS, and this was my first pregnancy) and was followed very closely by those doctors. We knew I was pregnant with triplets when we did the FIRST blood test letting me know if I was pregnant or not.

I was seen at least once per week, if not by an OB/GYN, then I was seen by a Perinatologist. (high risk pregnancy doctor)

I had a rescue cerclage because I was in the Perinatal Department, having a Level II ultrasound, and they caught it then. I was in the operating room the next morning getting stitched up.

Once that "high-risk" label is assigned, everything changes! Since my label was assigned within DAYS of becoming pregnant, I felt that I was very well taken care of, and watched like a hawk.

Maybe it was because the hospital where I conceived/delivered is considered in the top 10 for the US for IVF? Could be?

I'm actually finding this whole "Obesity Epidemic" more like an "Obesity PANIC".

[Fialka]

Great post Tripletmom and Playdoh.

I too have PCOS and did IVF to get pregnant. (8w2d).

I'm trying not to worry about it (and I'm not in Kaiser at least) but I know this whole thing is going to be a crapshoot.

I just hope my baby and I survive all this 'care' we're going to get.

F