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Health survey for england maternal obesity and pregnancy: Healthy weight services in England before, during and after pregnancy: a mixed methods approach

A systematic review and meta-analysis was undertaken to assess the association between maternal overweight or obesity and infant mortality.

Lucas Cox
Saturday, December 21, 2019
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  • Responses were received from 88 people of whom 39

  • Previous research has shown regional differences in the rate of maternal obesity and clear evidence of health inequalities in relation to a higher incidence of maternal obesity and its complications among women from Black and Ethnic Minority BME backgrounds and those who are socially deprived [ 2534 ].

  • Health Survey for England -Health, social care and lifestyles. Article Google Scholar 7.

  • Raised BMI is associated with increased short-and long-term adverse outcomes for mothers such as increased risk of maternal mortality, pregnancy induced hypertension, gestational diabetes, primary postpartum haemorrhage and interventional birth [ 5 ].

  • FF — Survey development and analysis, interview schedule development and analysis, writing the methods, results and discussion sections, drafting the full article. Gestation specific infant mortality

Children who are overweight and obese, aged 2 to 15

Results: Twenty-four records were included from screened. There are many questions and topics covered by the series of surveys and some questions are not reported in the publications each year. Article Google Scholar.

  • Accurate identification of maternal risk factors in pregnancy will help reduce adverse birth outcomes.

  • Between andthere has been a marked increase in the proportion of adults who are overweight or obese.

  • Health Survey for England -Respiratory health. Interestingly, within the raw data, maternal height and weight at booking were the two variables representing the most missing data on all the collected variables.

  • It also highlighted the need for rigorous evaluation of existing services and equitable provision of services particularly before and after pregnancy.

  • Limited evidence on interventions that positively impact on pregnancy or neonatal outcomes, coupled with no national guidelines on weight gain in pregnancy and National Institute of Health and Care Excellence NICE guidance that was seen to be out-of-date, made it difficult for providers to know what services to commission and how to effectively evaluate current services. Continuity of carer during pregnancy was also desired to assist with conversations and follow-up regarding healthy lifestyle.

Physical Activity for Pregnant Women. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. However, the precise mechanisms remain unclear. The promotion of healthy lifestyle and healthy weight before, during and after pregnancy have been suggested to reduce the risk of pregnancy and birth complications as well as to minimise the risk of obesity development and metabolic diseases such as type 2 diabetes in the long term [ 121314 ]. The variables were initially inspected using frequency counts by each ethnic group and 3 BMI outliers were subsequently removed, to avoid distorting the data.

The results regarding availability of services was consistent between the semi-structured interviews and the survey. A semi-structured interview schedule marernal by the survey results was developed see Additional file 2. Further requests were sent to LMS Chairs within regions where no initial responses were received. Conclusions There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Purposive sampling of women aged 16 and over, who delivered their infants between January and December was conducted, extracting a number of pre-identified variables. Maternal Obesity in the UK: Findings from a national project.

Associated Data

All interviews and focus groups were audio recorded and transcribed verbatim. Competing interests The authors declare that they have no competing interests. Any local evaluation described was by monitoring attendance or asking women for feedback, with changes incorporated into the service in response to any issues raised.

  • They also reported frustration at not receiving information such as attendance when it was requested from providers, so did not know whether further promotion of services was required.

  • Maternal obesity: pregnancy complications, gestational weight gain and nutrition.

  • Health Survey for England -Respiratory health. The constant cycle of commissioning, decommissioning, revamping and re-commissioning of services as funding was available made it difficult for practitioners to stay informed with service availability.

  • Therefore, maternal country of birth or length of residence was not established for this study.

  • Published : 22 June

Thematic representation of the interview findings The themes and health survey for england maternal obesity and pregnancy identified from qualitative data are presented in Fig. World Bank. One respondent felt it also led to NHS trusts all developing their own thing, when a lot of time and effort could be saved with national level input. Lack of money was the biggest obstacle reported. Training all healthcare professionals prior to registration was felt to be essential, so healthy eating is an integral part of the job from the start. It is essential therefore that healthcare professionals who have contact with women prior to pregnancy, during pregnancy and postpartum are informed of up-to-date local service provisions.

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Incorporating aspects such as weight maintenance and cooking skills into antenatal obesity and pregnancy was also suggested. National Center for Biotechnology InformationU. The importance of consulting the target population to better understand their service needs and to ensure services developed are relevant and appropriate cannot be overlooked [ 26 ]. This also made sense to providers given the increasing population levels of overweight and poor diet and the lower cost associated with embedding a universal service into existing provision, rather than paying for an additional service. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Google Scholar 2.

Limitations of this study This research was enhanced by the participants in both phases health survey for england maternal obesity and pregnancy the study representing a wide variety of occupations and including both commissioners and providers. Try magernal PMC Labs and tell us what you think. Previous research has shown regional differences in the rate of maternal obesity and clear evidence of health inequalities in relation to a higher incidence of maternal obesity and its complications among women from Black and Ethnic Minority BME backgrounds and those who are socially deprived [ 2534 ]. Open in a separate window.

This is in line with Public Health England who have recommended the application of an evidence based framework to ensure the embedding of appropriate pregnancu change techniques into interventions [ 26 ] and have provided a list of the most effective behaviour change techniques to use in future weight management interventions [ 27 ]. Health Survey for England - Healthy lifestyles: knowledge, attitudes and behaviour. They could include basic information provision such as the Eat Well Plate [ 18 ], safe exercise in pregnancy guidelines or the physical activity in pregnancy infographic [ 19 ] given by professionals such as midwives or health visitors. Abstract Background Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity.

Further information

PLoS One. Additional file 1. Received : 01 January

Health Survey for England -Updating and pregnancy trend tables to anv childhood obesity data. However, little is known about the pattern of service provision to support women and families to enhance their lifestyle and promote healthy weight gain at such an important life stage. J Health Visiting. Fair, F. View author publications. There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Observational studies reporting on the relationship between maternal overweight and obesity and infant mortality were included.

Respondents were also asked if the services provided, were for the women only or incorporated other family members into the service and whether service users obesity and pregnancy been involved when developing the service. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Results A total of 88 participants responded to the survey. Background and objectives: Despite numerous studies reporting an elevated risk of infant mortality among women who are obese, the magnitude of the association is unclear. Curr Cardiovasc Risk Rep. It is therefore important to ensure all healthcare workers are aware of related service provisions.

Two researchers undertook the analysis with the final themes agreed through discussion. To ensure these services are fit for purpose more robust evaluation is required. Results - online questionnaire Characteristics of respondents Responses were received from 88 people of whom 39 Individual interviews or focus groups were undertaken with a purposive sample of key stakeholders within one region of England. References 1. A guide to delivering and commissioning Tier 2 adult weight management services.

Page contents

Limitations of this study This research was enhanced by the participants in both phases of the study representing a wide variety of occupations and including both commissioners and providers. A semi-structured interview schedule informed by the survey results was developed see Additional file 2. Centre for Maternal and Child Enquiries. For babies, there are additional risks of stillbirth, large for gestational age, admission to neonatal units and neonatal mortality [ 67891011 ].

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Using revised anthropometric measures in Indian, Pakistani and Bangladeshi women has clinical implications for identifying risks associated with obesity and increased complications in pregnancy. White British, Indian, Pakistani and Bangladeshi were used in this analysis. Providing services for all women was felt to increase service uptake, by preventing mothers with a raised BMI feeling stigmatised. Themes within responses were identified using a simple content analysis. These results show Indian and Bangladeshi mothers may be underweight; a low body mass contributes towards increased pregnancy risks of a low birthweight infant or delivery preterm. Group interventions were especially felt to inhibit access for some women.

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Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Association between body mass index and cardiovascular disease mortality in east Asians and health survey for england maternal obesity and pregnancy Asians: pooled analysis of prospective data from the Asia Cohort Consortium. At the time of writing, the revised guidance on BMI for Asian women has not been incorporated into the NICE guidance for antenatal care or NICE guidance on diabetes in pregnancy, suggesting that pregnant South Asian women are currently less likely to be identified at higher risk of pregnancy complications, though a raised BMI. Any local evaluation described was by monitoring attendance or asking women for feedback, with changes incorporated into the service in response to any issues raised. KMD -Undertaking interviews, input into analysis, writing initial drafts of the introduction and discussion.

J Health Visiting. Health Survey for England - Healthy lifestyles: knowledge, attitudes and behaviour. Health Survey for England -Health and lifestyles. Results: Twenty-four records were included from screened. Resources The surveys include more topics than are reported on in the publications.

Metrics details. It aims to compare the prevalence of maternal overweight and obesity in women of South Asian origin i. Gurch Randhawa, Email: ku. Healthy weight service provision varies in different geographical areas across England.

Background

Abstract Background Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. There was a call for more pre-conception education, either through schools or a national campaign highlighting the risks to mother and child of being overweight at conception, to reduce the number of women with a raised BMI prior to pregnancy. A total of 88 participants responded to the survey. A recent review of behaviour change techniques used in gestational weight management trials has found these techniques are currently poorly reported [ 28 ].

Previous research has shown qnd differences in the rate of maternal obesity and clear evidence of health inequalities in relation to a higher incidence of maternal obesity and pregnancy its complications among women from Black and Ethnic Minority BME backgrounds and those who are socially deprived [ 2534 ]. Maternal obesity in the UK: findings from a national project. Semi-structured interviews Individual interviews or focus groups were undertaken with a purposive sample of key stakeholders within one region of England. National Institute for Health and Clinical Excellence. Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services.

The survey is used to estimate the proportion of people in England who have health conditions, and the prevalence of risk factors maternal obesity behaviours associated with certain health conditions. Providing services for all women was felt to increase service uptake, by preventing mothers with a raised BMI feeling stigmatised. Training all healthcare professionals prior to registration was felt to be essential, so healthy eating is an integral part of the job from the start. Only four services had been independently evaluated, either by an independent University or national evaluation of services such as Slimming World.

Page contents

Latest statistics. Manchester: National Institute for health and clinical excellence; Over a third of respondents reported service user involvement Fig. Clearer national leadership is also required on the commissioning requirements around maternal healthy weight to help reduce geographical variation and the potential health inequalities that this may cause.

The authors found that on obwsity application of revised BMI thresholds, the prevalence of obese South Asian women increased from Interestingly, within obesity and raw data, maternal height and weight at booking were the two variables representing the most missing data on all the collected variables. ASR uses a standardised score and helps to identify where in the contingency table of ethnicity x BMI threshold standard and revised the data deviated from expected counts and was either under or over represented i. The database cohort mean BMI was KMD -Undertaking interviews, input into analysis, writing initial drafts of the introduction and discussion.

  • PLoS One. Results - online questionnaire Characteristics of respondents Responses were received from 88 people of whom 39

  • There was a call for more pre-conception education, either through schools or a national campaign highlighting the risks to heapth and child of being overweight at conception, to reduce the number of women with a raised BMI prior to pregnancy. More concise, clearer and directive national guidance would also enable existing services to be better evaluated for effectiveness.

  • However, little is known about the pattern of service provision to support women and families to enhance their lifestyle and promote healthy weight gain at such an important life stage. Local Authority Declaration on Healthy Weight.

  • A theory-led overview of systematic reviews. The behavior change technique taxonomy v1 of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions.

  • Article Google Scholar 7.

However, little surey known about the pattern of service provision to support women and families to enhance their lifestyle and promote healthy weight gain at such an important life stage. The media propagated image of healthy eating and physical activity being middle-class and too expensive for women from deprived communities also needs addressing to reduce inequitable access. Results: Twenty-four records were included from screened. Commissioners should consider implementing strategies to reduce the barriers identified through the interviews especially as these are likely to affect women living in deprived areas disproportionately to their more affluent counterparts. Download citation. Health Survey for England [NS]. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England.

Further requests were sent to LMS Chairs within regions where no initial responses were received. Results of the survey are also summarised on the infographic in Additional file 3. Figure 1 shows the LMS distribution of respondents. Health Survey for England, Trend tables.

Background

Health Survey for England -Latest trends. Year-on-year fluctuations may not indicate real changes and can be within the margins of sampling error. Correspondence to Hora Soltani. Individual interviews or focus groups were undertaken with a purposive sample of key stakeholders within one region of England. Knowledge translation of research findings.

More needs to be done to formally evaluate services. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Commissioners should consider implementing strategies to reduce the barriers identified through the interviews especially as these are likely to affect women living in deprived areas disproportionately to their more affluent counterparts. The reasons for this are unclear. Competing interests The authors declare that they have no competing interests.

This study aimed to explore current service provision of maternal healthy weight services in England through a survey of LMS representatives and to determine the perspectives of key stakeholders on variation in heaalth provision and related barriers and facilitators locally. Health Health survey for england maternal obesity and pregnancy for England -Updating of trend tables to include childhood obesity data. The questionnaire was initially sent out on 12th Marchfollowed by a reminder on 24th April Excess coronary heart disease in South Asians in the United Kingdom. One respondent felt it also led to NHS trusts all developing their own thing, when a lot of time and effort could be saved with national level input. In addition, the outcomes from this study confirm that comparisons of BMI between mothers of South Asian ethnicity are indeed heterogenic. Int J Obes.

A recent review of behaviour change techniques used in gestational weight management trials has found these techniques are currently poorly reported [ 28 ]. Topics and measurements included in the surveys from to are listed here Explore the trends Information about Health Survey for England datasets. Published 20 January Commissioners should consider implementing strategies to reduce the barriers identified through the interviews especially as these are likely to affect women living in deprived areas disproportionately to their more affluent counterparts.

The proper evaluation of services snd also impeded by lack of money. Accepted : 18 June For babies, there are additional risks of stillbirth, large for gestational age, admission to neonatal units and neonatal mortality [ 67891011 ]. The national provider of information, data and IT systems for health and social care. Incorporating aspects such as weight maintenance and cooking skills into antenatal classes was also suggested.

Gestation specific infant mortality The results from this study are similar to those reported by Bryant et al. Providing services for all women was felt to increase service uptake, by preventing mothers with a raised BMI feeling stigmatised. Additional file 2.

Publication types

Baby Friendly Initiative. There was a call for more pre-conception education, either through schools or a national campaign highlighting the risks to mother and child of being overweight at conception, to reduce the number of women with a raised BMI prior to pregnancy. Past publications.

Provision of maternal healthy weight services survey. Evaluation of services was universally poor. Methods Dor mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Diabetes Care. Public Health England. Commissioners should consider implementing strategies to reduce the barriers identified through the interviews especially as these are likely to affect women living in deprived areas disproportionately to their more affluent counterparts. FF — Survey development and analysis, interview schedule development and analysis, writing the methods, results and discussion sections, drafting the full article.

Implement Sci. A recent review of behaviour change techniques used in gestational weight management trials has found these techniques are currently poorly reported [ 28 ]. Tailoring lifestyle interventions to low socio-economic populations: a qualitative study. Year-on-year fluctuations may not indicate real changes and can be within the margins of sampling error. National Institute for Health and Clinical Excellence.

  • ASR uses a standardised score and helps to identify where in the contingency table of ethnicity x BMI threshold standard and revised the data deviated from expected counts and was either under or over represented i.

  • Peer Review reports.

  • Clear communication with service users to ensure appropriate services are commissioned was considered key to ensure access.

Rebecca Garcia, Phone:Email: ku. The cohort mean weight is Research has shown that there is an increased risk of stillbirth [ 3 ] and congenital anomalies [ 7 ] in obese mothers. The variables were initially inspected using frequency counts by each ethnic group and 3 BMI outliers were subsequently removed, to avoid distorting the data. Google Scholar 4. Am J Obstet Gynecol. We are also thankful for the support of Charlene Mulhern, Anna Lucas, Catherine J Swann and Monica Davison from Public Health England for their invaluable contributions in disseminating the survey questionnaire and commenting on the project development.

Article Google Scholar. Health Survey for England - Updating of trend tables to include data. Only Health Survey for England -CVD and risk factors for adults, obesity and risk factors for children. Acknowledgements We are grateful to all the participants without whom this work was not possible.

Correspondence to Hora Soltani. Some areas provided information about bespoke programmes that women vor access such as aquanatal classes, Cook it Programmes, leisure centre partnerships or park walks. They also reported frustration at not receiving information such as attendance when it was requested from providers, so did not know whether further promotion of services was required.

Group interventions were especially felt to inhibit access for some women. Public Fro. Health Survey for England -Early results. A nationally representative study of maternal cartoons youtube in England, UK: trends in incidence and demographic inequalities in births, Baby Friendly Initiative. The authors found that on the application of revised BMI thresholds, the prevalence of obese South Asian women increased from Research has consistently shown that evidence translation is problematic [ 29 ] and calls have been made to utilise appropriate behaviour change techniques for health professional behaviour change [ 30 ].

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London: Public Health England; Knowledge translation of research findings. NHS England. Limitations of this study This research was enhanced by the participants in both phases of the study representing a wide variety of occupations and including both commissioners and providers. Baby Friendly Initiative. Health Survey for England - Physical activity and fitness. Competing interests The authors declare that they have no competing interests.

Additional file 3. Corresponding author. The results regarding availability of services was consistent between the semi-structured interviews and the survey. A semi-structured interview schedule informed by the survey results was developed see Additional file 2. Themes within responses were identified using a simple content analysis. Commissioners should consider implementing strategies to reduce the barriers identified through the interviews especially as these are likely to affect women living in deprived areas disproportionately to their more affluent counterparts. Health Survey for England -Trend tables.

  • Resources The surveys include more topics than are reported on in the publications. All authors have read and approved the final manuscript.

  • The Eatwell Guide.

  • Published : 22 June

Few services were targeted specifically at women with a raised body mass index. Hunt C, Rudolf M. Results of the survey are also summarised on the infographic in Additional file 3. More concise, clearer and directive national guidance would also enable existing services to be better evaluated for effectiveness. They could include basic information provision such as the Eat Well Plate [ 18 ], safe exercise in pregnancy guidelines or the physical activity in pregnancy infographic [ 19 ] given by professionals such as midwives or health visitors.

A five year forward view for maternity care. Health Survey for England, It is recognised that combining different research methodologies in mixed methods research can provide better understanding of research questions through triangulation of results collected from different sources [ 17 ]. Health Survey for England - Updating of trend tables to include data. You can also search for this author in PubMed Google Scholar.

Childbearing contributes to the rise of overweight and obesity in women [ 4 ]. Nature Publishing Group; ;—8. Family approaches included other family members being incorporated into the service, whole family activities for example cookery courses or proactive onward referral for family members. Previous research has shown regional differences in the rate of maternal obesity and clear evidence of health inequalities in relation to a higher incidence of maternal obesity and its complications among women from Black and Ethnic Minority BME backgrounds and those who are socially deprived [ 2534 ]. In other words, more South Asian women are at risk from pregnancy adversity as a consequence of being overweight or obese than the prevalence of white British mothers, when using the correct BMI metrics per maternal ethnicity.

Health Survey for England - Obesiy trends. There was a shift from focussing exclusively on weight onto healthy eating and activity. Metrics details. There are many questions and topics covered by the series of surveys and some questions are not reported in the publications each year. Consequently, enabling accurate identification of at-risk populations is essential for personalised care and targeted interventions as recommended [ 1718 ]. Manchester: National Institute for health and clinical excellence; Maternal obesity in the UK: findings from a national project.

The questionnaire was initially sent out on 12th Marchfollowed preynancy a reminder on 24th April Latest statistics. For babies, there are additional risks of stillbirth, large for gestational age, admission to neonatal units and neonatal mortality [ 67891011 ]. Department of Health and Social Care. Results A total of 88 participants responded to the survey. Other trend tables, e.

One respondent felt it also led to NHS trusts all developing their own thing, when a lot of time and effort could be saved with national level input. The funders have no involvement in the research or publication. It is known that maternal weight and risk of adversity increases with maternal age [ 828 ]. About this publication The Health Survey for England series was designed to monitor trends in the health, and health related behaviours, of adults and children in England.

Nasreen Ali, Email: ku. This was achieved using syntax code in SPSS. Ans The surveys include more topics than are reported on in the publications. To our knowledge, only one previous published paper addresses the issue of BMI metrics in pregnant South Asian mothers [ 16 ]. Weight management before, during and after pregnancy.

  • This is necessary both to maximise the use of available services and to ensure consistent reliable messaging around maternal healthy weight. Malcolm Griffiths, Email: ku.

  • Additional file 2.

  • BMC Pregnancy Childbirth. Sussex: Routledge;

  • The reasons for this are unclear. Methods Design and study population Retrospectivecross-sectional analysis of routinely collected secondary data from Ciconia Maternity information System CMiS at the Luton and Dunstable University Hospital was used.

  • Iacobucci G. Physical Activity for Pregnant Women.

Other trend tables, e. Improving prevention and population health - Workstream 9. Weight management before, during and after pregnancy. Health Survey for England -Respiratory health. All interviews and focus groups were audio recorded and transcribed verbatim. There was a high degree of inconsistency of service provision in different geographical areas. Method A mixed methods approach was undertaken.

Health Survey for England. Nature Publishing Group; [cited Oct 28];—8. The database cohort mean BMI was Impact of perinatal weight change on long-term obesity and obesity-related illnesses. Figure 1 shows the LMS distribution of respondents.

About this article. Article Google Scholar 5. About this publication The Health Survey ane England series was designed to monitor trends in the health, and health related behaviours, of adults and children in England. Abstract Background Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity.

Conclusions There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. It is recognised that combining different research methodologies in mixed methods obsessive compulsive disorder cartoons youtube can provide better understanding of research questions through triangulation of results collected from different sources [ 17 ]. Gestational weight gain and child adiposity at age 3 years. Health Survey for England - Updating of trend tables to include data. This study showed clear variation in maternal obesity service provision across England with a complete lack of accessible services in a number of areas, especially for women with a high BMI.

  • View author publications. This could be from no service availability to availability across all stages of the childbearing cycle.

  • A recent review of behaviour change techniques used in gestational weight management trials has found these techniques are currently poorly reported [ 28 ]. Clear communication with service users to ensure appropriate services are commissioned was considered key to ensure access.

  • Gestation specific infant mortality Some areas provided information about bespoke programmes that women could access such as aquanatal classes, Cook it Programmes, leisure centre partnerships or park walks.

  • This needs to include evaluation of the effective behaviour change components of the service through frameworks such as Michie et al. Evaluation of services was universally poor.

Ethics declarations Ethics approval and consent to for england maternal Ethical approval was obtained prior to commencing data collection Sheffield Hallam University Converis Number ER InWHO determined that the existing BMI thresholds were inappropriate to be applied to individuals of Asian ethnicity, as the increased risk of adverse morbidity has been found to occur in lower BMI classifications [ 1314 ]. Health Survey for England - Updating of trend tables to include data. A guide to delivering and commissioning Tier 2 adult weight management services. World Bank.

Conclusions: Our results suggest pregnancy the odds of having an infant death are greater for obese mothers and that this risk may increase with greater maternal BMI or weight; however, residual confounding may explain these findings. PLoS One. Respondents were also asked if the services provided, were for the women only or incorporated other family members into the service and whether service users had been involved when developing the service. The Health Survey for England series was designed to monitor trends in the health, and health related behaviours, of adults and children in England.

There is a need for more robust evaluation of services to ensure they are fit for purpose. Competing interests The authors declare that they have no competing interests. Malcolm Griffiths, Email: ku. References 1. Metrics details.

Suggestions made by interviewees to encourage better access or englwnd effective service provision, included prioritisation, a change in focus and co-design of services. Healthy weight service provision varies in different geographical areas across England. A response was received from 23 of the 44 LMS Download references. Of the fourteen respondents who did not report which LMS they were from, 11 took no further part in the survey. Other trend tables, e.

Implementing preventative health survey for england maternal obesity and pregnancy that provide opportunities to enhance lifestyle choices throughout preconception, pregnancy and the postpartum with the aim of reducing the burden of maternal obesity and its associated complications have been identified as top priorities [ 15 ]. Health Survey for England - Health of ethnic minorities, Headline results. Latest statistics. An online questionnaire was distributed and analysed. The results regarding availability of services was consistent between the semi-structured interviews and the survey. Only four services had been independently evaluated, either by an independent University or national evaluation of services such as Slimming World.

  • American Diabetes Association 6.

  • BMC Public Health.

  • Published : 22 June

  • Article Google Scholar This covered services currently provided, services that respondents would like to see provided and factors interviewees felt were facilitators or barriers to service provision or access.

  • The views and opinions expressed within the article are those of the authors and do not necessarily reflect the views Public Health England.

  • The main barrier identified by participants to providing and commissioning healthy weight services for the childbearing population was the lack of, or inconsistency in, funding.

Curr Cardiovasc Risk Rep. Skip to main content. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use. Health Survey for England -Trend tables.

American Diabetes Association 6. This needs to include evaluation of the effective behaviour change components of the service through frameworks such as Michie et al. Indian, Pakistani, Bangladeshi, Asian Other were 2. Services reporting that they had been evaluated, used a snd approach or had involved service users. Main outcome measures: Percentage of mothers stratified by ethnicity Indian, Pakistani, Bangladeshi and white British who are classified as overweight or obese using standard and revised World Health Organisation BMI thresholds. We are also thankful for the support of Charlene Mulhern, Anna Lucas, Catherine J Swann and Monica Davison from Public Health England for their invaluable contributions in disseminating the survey questionnaire and commenting on the project development. The authors found that on the application of revised BMI thresholds, the prevalence of obese South Asian women increased from

Correspondence to Hora Soltani. Ethics declarations Ethics approval and consent to participate Ethical approval was obtained prior to commencing data collection Sheffield Hallam University Converis Number ER Metrics details.

Survey kbesity were also geographically well dispersed across England and the interviewees covered numerous councils and NHS trusts. Statistics have shown an increased incidence obesity and pregnancy stillbirth in Pakistani mothers compared to other ethnic groups [ 27 ]. Curr Cardiovasc Risk Rep. This study compares the prevalence of maternal obesity in Indian, Pakistani, Bangladeshi and white British women using standard and Asian-specific BMI metrics. The proper evaluation of services was also impeded by lack of money. Money restrictions also equated to time restrictions within appointments, meaning discussions around healthy eating or referral to available services were always a low priority for midwives needing to address many other topics.

  • Hhealth was provided at the start of the survey and consent was assumed inherent for the participants who completed the online survey voluntarily. This study is the first to our knowledge to apply and compare the revised BMI thresholds for South Asian individuals, in the UK with standard BMI thresholds, bringing attention to important differences between pregnant South Asian mothers i.

  • It is recognised that combining different research hdalth in mixed methods research can provide better understanding of research questions through triangulation of results collected from different sources [ 17 ]. Providing free services, in places with good transport links, on-site childcare, high visibility through good marketing and de-centralised services to reduce the distances women have to travel were all considered vital to improve service accessibility.

  • We are also thankful for the support of Charlene Mulhern, Anna Lucas, Catherine J Swann and Monica Davison from Public Health England for their invaluable contributions in disseminating the survey questionnaire and commenting on the project development.

  • Download PDF.

Many respondents wanted further maternal obesity services, either bespoke or the commissioning of programmes such as Slimming World for all pregnant women. Cite this article Fair, F. Further requests were sent to LMS Chairs within regions where no initial responses were received. It is essential therefore that healthcare professionals who have contact with women prior to pregnancy, during pregnancy and postpartum are informed of up-to-date local service provisions.

This could be from oobesity service availability to availability across all stages health survey for england maternal obesity and pregnancy the childbearing cycle. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. Methods A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Gestational weight gain and child adiposity at age 3 years. Weight management before, during and after pregnancy. Health Survey for England -Health and lifestyles. Baby Friendly Initiative.

Few services were targeted specifically at women with a raised body mass index. More needs to be done to formally evaluate services. Improving prevention and population health - Workstream 9. Supplementary information.

Englanf eating, weight management and physical activity services for all women were varied in nature from nothing or the provision of very basic information to structured weight management or physical activity programmes. J Pregnancy. The impact of HENRY on parenting health survey for england maternal obesity and pregnancy family lifestyle: a national service evaluation of a preschool obesity prevention programme. It is essential therefore that healthcare professionals who have contact with women prior to pregnancy, during pregnancy and postpartum are informed of up-to-date local service provisions. This needs to include evaluation of the effective behaviour change components of the service through frameworks such as Michie et al. Funding to public health budgets has seen significant cuts over recent years which has had significant effects on public health services across the board [ 31 ].

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For some statistics such as height, weight, overweight and obesity, smoking, general health, longstanding illness and acute sickness data from the s onwards are published in trend tables. HS — Development and oversight of the project, assisting with survey development and analysis, interview schedule development and analysis, healfh on the drafted article. Respondents felt limited specific guidance on acceptable weight gain during pregnancy as standards to measure services against hindered evaluation. Work commitments and employers not facilitating access to healthy lifestyle appointments also made it difficult for women to benefit from services. The centiles take into account the gender of the child and their age on the day of measurement. For babies, there are additional risks of stillbirth, large for gestational age, admission to neonatal units and neonatal mortality [ 67891011 ].

J Pregnancy. At the time of writing, the revised guidance on BMI for Asian women has not been incorporated into the NICE guidance for antenatal care or NICE guidance on diabetes in pregnancy, suggesting that pregnant South Asian women are currently less likely to be identified at higher risk of pregnancy complications, though a raised BMI. In all LMS where there were multiple respondents it was noted that the services reported varied between respondents. It prevented services being commissioned, prevented investment in services and inhibited service delivery. Tackling obesities: future choices — project report. Gestational weight gain and child adiposity at age 3 years. The authors found that on the application of revised BMI thresholds, the prevalence of obese South Asian women increased from

Support Center Support Center. The contribution of maternal obesity in adverse birth outcomes is england maternal obesity beginning to become known, with a recent study flr routine collected data in London — demonstrated that obese women of South Asian origin i. The long-term effects of stillbirth on women with and without gestational diabetes: a population-based cohort study. Gestational weight gain and child adiposity at age 3 years. Training all healthcare professionals prior to registration was felt to be essential, so healthy eating is an integral part of the job from the start.

It is essential therefore that healthcare professionals who have contact with women prior to pregnancy, during pregnancy and postpartum are informed of up-to-date local service provisions. Additional file 3. Int J Obes. London: Sage Publications; Survey respondents were also geographically well dispersed across England and the interviewees covered numerous councils and NHS trusts. A guide to delivering and commissioning Tier 2 adult weight management services.

New York; References 1. This study uses de-identified secondary data. Tailoring lifestyle interventions to low socio-economic populations: a qualitative study.

This needs to include hfalth of the effective behaviour change components of the service through frameworks such as Michie et al. Transcripts were initially read to ensure familiarity with the data. Thematic representation of the interview findings The themes and subthemes identified from qualitative data are presented in Fig. London; Implement Sci.

Therefore, maternal country of birth or length of residence was not established for this study. Additional file 3. Please review our privacy policy. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data. National Obesity Observatory. NHS England.

If material is not included in the article's Creative Commons licence and sugvey intended use is not permitted by statutory regulation or exceeds health survey for england maternal obesity and pregnancy permitted use, you will need to obtain permission directly from the copyright holder. Family approaches included other family members being incorporated into the service, whole family activities for example cookery courses or proactive onward referral for family members. There was a shift from focussing exclusively on weight onto healthy eating and activity. References 1. Service provision for women with a raised body mass index Similarly to the survey, there were few services specifically for women with a raised BMI.

Food Active. BMJ Open. Supplementary information. Topics and measurements included in the surveys from to are listed here Explore the trends Information about Health Survey for England datasets. The reasons for this are unclear. Similar and disparate codes were developed into themes.

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