A study of more than 60,000 women over seven years, living in South-Eastern Melbourne, has looked at cardiometabolic risk factors, both pre-conception and during pregnancy, finding what is essentially a ticking time-bomb of “unsustainable health and economic burden that necessitates urgent public health initiatives.”
The study, led by Dr Yitayeh Belsti, Professors Kirsten Palmer and Helena Teede, all from Monash University, and published in the journal, BMJ Open, studied 63,232 women who attended the Monash Health network of hospitals between 2016 and 2022 to give birth, 40 per cent giving birth for the first time.
Importantly the South-Eastern area of Melbourne is very diverse, and over 60 per cent of the cohort were born overseas, from 167 countries.
Over the seven years of the study, the researchers found an increase in:
- Obesity: from 21 to 26 per cent.
- Gestational diabetes mellitus: from 16 to 28 per cent.
- Caesarean delivery: from about 29 to 38 per cent.
However, average gestational or pregnancy weight gain, premature births and special care admissions declined from 12.6-11.6 kg, 6.3%-4.9% and 24.2%-14.1%, respectively.
During the COVID-19 lockdown period, maternal weight increased, the odds of gestational diabetes and induced birth also increased by 8.0%, whereas the odds of caesarean section decreased by 5.0%.
In 2020, more than half of Australian birthing mothers had a body mass index or BMI >25 kg/m2, in the higher range. According to Dr Belsti, social factors are driving women to birth later and our food policies and processed food supply are escalating weight, driving this ticking time bomb. “Increasing age and high BMI also drive pre-pregnancy cardiometabolic conditions, such as Type 2 diabetes and hypertension, and pre-pregnancy BMI status is also closely associated with greater gestational weight gain,” he said.
Professor Kirsten Palmer noted that “Lockdown restrictions during the COVID-19 pandemic further impacted physical activity and diet, impacting pre-pregnancy BMI and gestational weight gain.”
“Pre-pregnancy and pregnancy-related cardiometabolic conditions can increase complications for mother and baby, including increasing future risk of obesity, type 2 diabetes mellitus and cardiovascular disease in the mother and also her children – all of which is associated with a dramatic rise in healthcare needs and costs.”
Professor Teede said the results are reflective of trends across the country and indicate the need for urgent national action. This is vital to support women in healthier lifestyles before and during pregnancy, keep mums and bubs healthy and mitigate pregnancy complications and future cardiometabolic risk. “Ultimately. Australia must join the over 100 countries with sugar tax and protective public health policies. We also need to offer women coaching support for healthy lifestyle including physical activity, and healthy diet intake, which are proven to help mums stay healthier and lower the risk of gestational diabetes and hypertensive disorders of pregnancy, improving maternal and newborn outcomes.”
Contact:
Monash Centre for Health Research and Implementation (MCHRI)
T: +613 8572 2667, info.mchri@monash.edu
