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Maternal Deaths Linked To Obesity

Ruzanna Harutyunyan's picture

Nearly seven out of 10 women who died from natural causes within a year after pregnancy were either obese or overweight, according to a new study of 64 such deaths in Virginia between 1999 and 2002.

Virginia’s Maternal Mortality Review Teamreviewsthe deaths of women within a year of pregnancy regardless of the cause of death. There were 86 such deaths in the four-year period studied, of which the teamobtained height and weight information before childbirth in 64women. Among this group, 42, or 66 percent, were either obese or overweight.

Nearly one-third of these women died from chronic conditions such as heart disease. Obesity rarely was noted as a risk factor in prenatal records of these 64 women, although many of them suffered from hypertension or diabetes, known to be caused or exacerbated by obesity.

Obesity has a significant impact on the health of all Virginians and the incidence of illnesses associated with being overweight, including hypertension, Type 2 diabetes and certain cancers, is on the increase. “These conditions adversely affect the health of women of all ages and races and complicate pregnancy, delivery and the health of future generations,” said the review team in their report.

“It is important to understand the impact that being overweight or obese has upon women who are pregnant because so many of these deaths might have been prevented,” said State Health Commissioner Karen Remley, M.D., MBA. “We know from research that obesity and improper nutrition in mothers are among the causes of infant mortality. We also know that the likelihood of childhood obesity increases when parents are overweight.”

Commissioner Remley noted that the Virginia Department of Health offers Virginians a community-based program, CHAMPION, that targets obesity prevention and weight control.

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The maternal mortality study was coordinated by the Virginia Department of Health’s Office of Family Health Services and the Office of the Chief Medical Examiner. Dr. Leah Bush, Virginia’s Chief Medical Examiner, said that “nearly all of the women who died were seen by health care providers during the year before their death. The team in their report strongly recommended that health care providers educate their patients about the risks associated with being overweight or obese, especially during pregnancy.”

Among the recommendations of the review team:

* all employers in Virginia provide a health improvement plan that includes such components as healthy nutrition, weight reduction and healthy weight management;

* all schools in Virginia participate in the Governor’s Nutrition and Physical Activity Scorecard, which provides incentives for implementing best practices supporting proper nutrition and increased physical activity;

* all providers of pregnancy-related services promote the use of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) by providing program information and eligibility requirements to all pregnant women and new mothers, and;

* the General Assembly should consider requiring all third-party payers to support dietary counseling, education and nutrition therapy for patients whose body mass index is above 30.

“For a good part of the last century maternal death rates were declining, but that trend leveled off in 1982. Despite advances in medicine since then and despite considerable research on risk factors, there has been little improvement in the past 26 years,” Dr. Remley said. “This report, including its recommendations, is a powerful wake-up call for all Virginians. Proper nutrition and more active lifestyles provide lifelong benefits for parents and children alike.”