Obesity in pregnancy has been cited as the most common reason for babies dying in the womb.
A 2006-2007 study undertaken by the Queen Elizabeth Hospital, under the direction of Senior Registrar in the Department of Obstetrics and Gynaecology, Dr. Bayo Ogunbiyi, has revealed that 90% of women who experienced a still birth were overweight.
According to the medical practitioner, a baby is said to be still born if it dies in the womb after 28 weeks. Still births in 2006 registered at 7.9 per 1000 births while in 2007 they moved to 8.8 per 1000 births. The majority of these occurred in women between the ages of 20 and 25.
The finding on overweight has been deemed by Dr. Ogunbiyi as “not coincidental”. In an interview with the Government Information Service he said: “The commonest cause of still births in most places is chronic diseases – hypertensive disease of pregnancy called pre-eclampsia, or diabetes.
We looked at other factors and pre-eclampsia was occurring in one out of 10 women, whereas with obesity this figure was nine out of 10.”
Stressing the importance of addressing the issue of obesity, he said: “We need to highlight to our women that being excessively overweight before you get pregnant carries a risk not only to you but to the unborn child.”
While accepting the notion that obesity seemed to be “a cultural thing” in Barbados, Dr. Ogunbiyi suggested that it was a matter of balancing nature and nurture – the genetic pre-dispositions of individuals vis-a-vis what they ate, did and the environment in which they lived. He said: “Even though there is a cultural pre-disposition it is not an inevitable thing to be obese. It is something that can be controlled, especially at the child-bearing age.”
The Senior Registrar expressed concern about women in their 20s since the study showed that they were the ones encountering a number of still births where generally this would occur in women over the age of 35, and particularly those over 40.
He explained: “If you look at the compound statistics and do regression you would find that the main problem still comes out as obesity because these women [aged 20 to 25] are at the right age and are at the right amount of pregnancies. In other words, they haven’t had too many pregnancies; they don’t have other pre-disposing factors except obesity. This is why it is so important to address this issue.”
Dr. Ogunbiyi also disclosed that some studies showed Afro-centric ethnic groups having a higher number of negative outcomes in pregnancy. But, he pointed out that an indepth examination of them revealed that many of those persons who were obese also had low incomes along with issues such as alcohol and drug abuse in their lives. He stressed: “It is not ethnicity per se… the single most important factor in our Barbados study was overweight.”
Women contemplating pregnancy were offered advice: “Where you are before you get pregnant is a lot more influential on the outcome of your pregnancy than what happens in the pregnancy, in most cases.”
The Senior Registrar advised that prior to pregnancy women should watch their weight and ensure that they take supplements, like folic acid and iron, and, during pregnancy should always communicate with their doctors, take the multivitamins given and never use things without first consulting the doctor. He added: “If you find you are pregnant and obese see your doctor and let him make a plan so that you can have a good outcome.”
While there are no symptoms to indicate whether a pregnancy would end in a still birth, the warning to women over seven months (28 weeks) who notice reduced movement in their babies throughout the day is to contact the doctor and go to the hospital.
Dr. Ogunbiyi explained: “A baby that is well moves about… a baby that is unwell has reduced movement. We can try to find out the cause of the reduced movement and decide what interventions are necessary. Reduced movement is perhaps the only thing the mother can probably use as a marker.”
The two-year study on still births in Barbados was undertaken to determine the reasons for their occurrence and the unique features that are preventable and correctable.