Overweight and obesity represent a significant health problem with Australian population data indicating that 44.4% of women ages 18-44 years are overweight or obese (Body Mass Index [BMI] ≥25kg/m2). Recent South Australian data indicates 50% of women entering pregnancy are overweight or obese. Increasing maternal BMI in pregnancy is associated with well-documented adverse pregnancy outcomes, both for women and their infants, including preeclampsia, gestational diabetes, macrosomia and perinatal death. Outside of pregnancy, overweight and obesity contribute significantly to poor female reproductive health, including reduced fertility, pelvic organ prolapse and endometrial hyperplasia or cancer. While there is considerable literature describing these associations, there is more limited information available how overweight and obesity impact on clinical care, and what modifications are being made by practitioners when caring for this group of women.
To conduct a survey of practice of fellows and trainees of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists evaluating current obstetric and gynaecologic care for women who are overweight or obese.
An online or mail questionnaire was sent to 2,251 fellows and trainees of RANZCOG, utilising the college register, asking questions related to current care practices in obstetrics and gynaecology for women who are overweight or obese. Questions related to participant demographics, an estimation of the prevalence of overweight and obesity in their practice, and management practices when caring for women with an increased body mass index.
A total of 852 (37.9%) questionnaires were completed between March and June 2012. Practitioners indicated an increase in referrals and investigations for women who were overweight or obese. Interventions aimed at reducing possible complications were also recommended more frequently.
Practitioners report a high rate of compliance with currently available guidelines, thus making appropriate modifications to clinical care for this high risk group of women.