Sunday 23 July 2017

Overweight expectant mums pose health risk to unborn children, says Holles St Master

Dr Rhona Mahony, master of Holles Street Hospital.
Dr Rhona Mahony, master of Holles Street Hospital.
Eilish O'Regan

Eilish O'Regan

The National Maternity Hospital is grappling with the challenges posed by an ageing and increasingly overweight cohort of expectant mums.

More than a third of expectant mothers who attend the National Maternity Hospital in Holles St are now overweight, raising the risk both for themselves and their unborn baby.

One in eight pregnant women at the nation's busiest maternity unit is actually classed as obese, posing even more serious medical risks.

The hospital's master Dr Rhona Mahony has revealed the scale of the problem of overweight-mothers-to-be.

She warned they have "all the attendant medical risk including miscarriage, congenital malformation, gestational diabetes".

Gestational diabetes can develop in women during pregnancy because the mother's body is not able to produce enough insulin.

And she noted that overweight women risk increased and more complicated intervention by medics during their pregnancy.

At the same time, almost 40pc of women attending the hospital are over 35 years old, which is also associated with a range of adverse outcomes.

These include miscarriage and chromosomal anomalies such as Down Syndrome.

The increasingly complex cases facing the hospital, where 9,389 babies were born last year, are highlighted in its annual clinical report for 2015.

The report comes as the National Perinatal Epidemiology Centre in UCC found that more than half of Irish mothers who lost an infant in the weeks before or after birth were either overweight or obese.

The centre traced women who experienced perinatal loss in all units across the country from 2011 to 2014.

Complications

Dr Paul Corcoran, one of the report's authors, warned that addressing levels of obesity and smoking in pregnancy is crucial because of the wide range of complications they can trigger.

The perinatal mortality rate - recording deaths of babies around the time of birth - was 4.4 per 1,000 in Holles Street, which had no maternal deaths at all last year.

But Dr Mahony warned: "It is clear that the volume and complexity of our caseload continues to increase, creating continued challenges as we continue to operate with inadequate resources and grave infrastructural challenges."

The Caesarean section rate rose to 25.9pc and obesity and older mothers are also factors in this trend.

Other reasons that increase the risk of a C-section include having had a previous section or other medical conditions.

The most recent HSE report on all 19 maternity units across the country show the national rate was 29.6pc, although this disguises major variations nationwide.

Dr Mahony also warned that the rise in heavy bleeding in women after giving birth "should be of major concern".

This is partly explained by women having children at an older age. She said that postpartum haemorrhage has "always been among the leading direct causes of maternal death" but it is also a relatively common obstetric emergency.

"Advances in maternal case have helped prevent death from obstetric haemorrhage but the frequency of haemorrhage means that severe maternal morbidity and mortality remains a constant challenge in this context," she said.

Meanwhile,Dr Mahony stood firm behind the insistence of the National Maternity Hospital to maintain its independence if it moves to the campus of St Vincent's Hospital.

Irish Independent

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