Abstract
BackgroundMaternal obesity increases women’s risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women (who are born or settled) in the UK experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women. This study compares the prevalence of maternal obesity in Indian, Pakistani, Bangladeshi and white British women using standard and Asian-specific BMI metrics.MethodRetrospective cross-sectional analysis using routinely recorded secondary data in Ciconia Maternity information System (CMiS), between 2008 and 2013. Mothers (n = 15,205) whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian. Adjusted standardised residuals and Pearson Chi-square. Main outcome measures: Percentage of mothers stratified by ethnicity (Indian, Pakistani, Bangladeshi and white British) who are classified as overweight or obese using standard and revised World Health Organisation BMI thresholds.ResultsCompared to standard BMI thresholds, using the revised BMI threshold resulted in a higher prevalence of obesity: 22.8% of Indian and 24.3% of Bangladeshi and 32.3% of Pakistani women. Pearson Chi-square confirmed that significantly more Pakistani women were classified as ‘obese’ compared with white British, Indian or Bangladeshi women (χ2 = 499,88 df = 9, p < 0.001).ConclusionsThere are differences in the prevalence of obese and overweight women stratified by maternal ethnicity of white British, Indian, Pakistani and Bangladeshi. Using revised anthropometric measures in Indian, Pakistani and Bangladeshi women has clinical implications for identifying risks associated with obesity and increased complications in pregnancy.
Highlights
Maternal obesity increases women’s risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women in the United Kingdom (UK) experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women
Compared to standard BMI thresholds, using the revised BMI threshold resulted in a higher prevalence of obesity: 22.8% of Indian and 24.3% of Bangladeshi and 32.3% of Pakistani women
The results showed that white British women were significantly over-represented in the 18-25 kg/m2 group (ASR = 20.2), in contrast to Pakistani mothers who were significantly underrepresented in the 18.5-23 kg/m2 group (ASR = −15.8)
Summary
Maternal obesity increases women’s risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women (who are born or settled) in the UK experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women. Existing evidence shows that South Asian women in the United Kingdom (UK) (i.e. Indian, Pakistani, Bangladeshi women) [1] have higher rates of adverse birth outcomes, including perinatal mortality, compared with white British or white Other mothers [2, 3]. Guidance has been published that identifies lower risk thresholds; namely: 23–27.5 kg/m2 as ‘increasing risk’ (or overweight) and greater than 27.7 kg/m2 as ‘increased’ risk (or obese) [11, 15] These are aimed to identify health risks earlier, such as diabetes, cardiovascular disease and hyperlipidaemia, which are known to occur in higher prevalence in individuals of South Asian origin [10, 11]. At the time of writing, the revised guidance on BMI for Asian women has not been incorporated into the NICE guidance for antenatal care or NICE guidance on diabetes in pregnancy, suggesting that pregnant South Asian women are currently less likely to be identified at higher risk of pregnancy complications, though a raised BMI
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