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Factors associated with maternal obesity and obstetric outcomes among South Asian and European women
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Ghafar, Nor Asyikin Abd (2018) Factors associated with maternal obesity and obstetric outcomes among South Asian and European women. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3490853~S15
Abstract
OBJECTIVE: To identify the prevalence of maternal obesity, examine the association between maternal obesity and adverse pregnancy outcomes and explore the differences in lifestyle of obese pregnant women in first generation South Asians versus later generation South Asians in the West Midlands and Europeans.
DESIGN: A mixed methods parallel convergent study. Quantitative Study: Population based observational study in the West Midlands, comprising secondary data analysis using the Perinatal Institute dataset. A total of 141,314 completed pregnancies from 2009 – 2012 were studied including 120,481 European (85.3 %) and 20,833 South Asian (14.7%). Qualitative Study: Interviews with South Asian and European obese pregnant women attending the antenatal clinic at UHCW, Coventry, and with health professionals to explore the factors influencing obesity in pregnancy. The sample was 15 obese South Asian pregnant women (9 first generation, 6 later generation), 15 European pregnant women and 12 health professionals (4 Obstetricians, 1 Dieticians and 7 Community Midwives).
MEASUREMNTS Quantitative Data: Prevalence of maternal obesity, antenatal and foetal complications and perinatal mortality, presented as raw frequencies and adjusted odds ratios with 95% confidence intervals following multivariate regression analysis. Qualitative Data: Views and behaviour concerning food consumption, physical activity and other related factors of obese pregnant women and health professionals.
RESULTS Quantitative Study: Using WHO BMI General Classification, prevalence of obesity among European women (21.2%) was slightly higher compared to South Asian women. However using WHO BMI Asian Specific Classification, the prevalence of obesity among South Asian later generation women increased from 15.5% to 29.3%, and for South Asian first generation women increased from 11.6% to 25.5%. A similar trend was seen for the prevalence of maternal obesity amongst the South Asian subgroups. Maternal obesity increased various obstetric outcomes. South Asian women either first or later generation had higher prevalence of developing GDM when compared to European women. South Asian first generation also had the highest risk to have macrosomic baby when compared to the South Asian later generation and European women as a reference. Qualitative Study The lifestyles of some obese pregnant women are no different between the period before pregnancy and pregnancy itself. Most of the health professionals agreed that obese women should be given advice to lose weight before getting pregnant. South Asian obese women need to increase their capability on taking a proper diet, exercise regularly following the recommendation, increased knowledge related to weight management, diet and physical activity to increase their motivation to practice healthy lifestyle. Better opportunity for women of lower socioeconomic status, time management, and social influenced and support may increase the chance of practising a healthy lifestyle. Thus, health professionals need to give specific advice based on the pregnant women’s need using specific guidelines and tools.
CONCLUSION Using the WHO Asian Specific BMI Classification increases the prevalence of maternal obesity either among South Asian born in UK or not born in UK. Being obese has a significant impact on increasing the risk of gestational diabetes, hypertensive disease during pregnancy, caesarean section, low birth weight, macrosomia among South Asian women. However, the risk differs between the ethnic groups. Preconception services on weight management and specific guidelines for this group are needed.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics |
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Library of Congress Subject Headings (LCSH): | Obesity, Pregnancy -- Complications, South Asians -- Health and hygiene, South Asians -- Health and hygiene -- Great Britain, South Asians -- Women -- Great Britain | ||||
Official Date: | March 2018 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Robertson, Wendy ; Purkis, Judith ; Hundt, Gillian ; Gardosi, Jason ; Quenby, Siobhan | ||||
Format of File: | |||||
Extent: | xix, 428 leaves : illustrations, charts | ||||
Language: | eng |
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