An evaluation of the impact of a midwife-led maternal obesity service on pregnancy outcomes and childhood obesity
Obesity has been associated with an increased risk of perinatal mortality and morbidity (CEMACH 2007). Similarly increased gestational weight gain (GWG) has shown to be associated with adverse outcomes such as increased risk of macrosomia, interventional birth, maternal weight retention (Viswanathan 2008) and childhood obesity (Tie 2014) as well as reduced incidence of breastfeeding (Li 2003). The primary aim of the study is to evaluate the relationship among weight management service provision, maternal BMI, gestational weight gain and pregnancy outcomes, as well as weight changes in the offspring and to provide independent, robust evidence for a nationally recognised, innovative midwife-led obesity management service in Northern England. The project will involve a retrospective comparative study of outcomes in women with access to the ‘Monday clinic’ service in Doncaster and Bassetlaw compared to matched controls from the neighbouring NHS trust of Barnsley. Audit data has shown this service to be effective at reducing GWG, however an independent evaluation is needed to allow national credibility and the potential for rolling out the service. Links to childhood obesity will also be explored through linkage with the IT system (SystmOne). Since 2010 maternal data has been linked electronically to child data with health visitors and school nurses recording infants' weight and height at 10-14 days, 6-8 weeks, 9-12 months, 2-2.5 years and school entry (5 years of age). This provides an excellent opportunity for data linkage for long term follow up in relation to child anthropometric data.