maternal weight and the obesogenic environment in nova scotia

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Maternal weight and the obesogenic environment in Nova Scotia Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney

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Maternal weight and the obesogenic environment in Nova Scotia. Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney. “…today’s principal neglected public health problem...” (WHO, 1997) - PowerPoint PPT Presentation

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  • Maternal weight and the obesogenic environment in Nova ScotiaSara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney

  • todays principal neglected public health problem... (WHO, 1997)one of the most important medical and public health problems of our time..." (Prof. Philip James, IOTF Chairman) given the prevalence of childhood obesity, and given its contribution to many diseases, this is the first generation that may not live as long as their parents (Dr. Kellie Leitch)The obesity time bomb

  • Obesity rates, by province and sex, 2004

  • Overweight and obesity rates: children and youth, by province, 2004

  • So, what happened?www.foresight.gov.uk

  • Pregnancy and post-partum: an ideal time for intervention Obese mothers are at a high risk for many complications

    Children with obese parents are themselves more likely to be obese as adults

    Supportive programming for mothers is key to obesity prevention

  • No national surveillance system that routinely measures pregnancy weight in Canada

    Canadian Perinatal Surveillance system (CPSS) collects 27 health outcomes but not BMI of the mother

    The pregnant population in Canada

  • Provincial level population-based, computerized database with information on pregnancy outcomes

    Maternal/newborn data available for every pregnancy of > 20 weeks gestation, with a birth weight of 500g or more

    Data on self-reported pre-pregnancy weights from 1988The Atlee Perinatal Database

  • To describe the temporal, socio-economic and demographic trends in normal weight and obese pregnant women in Nova Scotia

    Part of a larger study investigating the influence of the obesogenic environment on maternal body weightObjective

  • Self-reported pre-pregnancy weights on women in NS (1988-2006)172,373 deliveries (2108 multiple births)normal weight = 55-75 kgmoderately obese = 90-120 kgseverely obese > 120 kg

    Analyses to look at trends in maternal body weight by: TimeAgeParitySESUrban/rural

    Methods

  • Subject characteristics

    School of Health Administration

  • 8.6 kg increase

  • Number of deliveries to women with pre-pregnancy weight >120kg

  • Maternal obesity: A provincial problem

  • Summary of resultsObese women:were slightly olderwere of lower SESgained less weight during pregnancywere more likely to live in rural areas

  • ConclusionsMaternal weights have increased dramatically over the last 20 years in Nova Scotia

    Deliveries in severely obese women have more than tripled since 1988

    These trends have implications for population health and health care deliveryMaternal and child healthStaffingResources

    Conclusions

  • What next?In-depth exploration of the influence of the obesogenic environment on maternal body weight

    Investigation of maternal obesity in the context of the child

    Recommendations for family-centred management and prevention

    What next?

  • Acknowledgements

    IWK Health Centre funding (Tarra Penney and Trevor Dummer)Reproductive Care Program of Nova Scotia (data access)

    Acknowledgements

    This slide compares obesity rates in different provinces and again we can see that rates in AC are above the national average. So what is going on? People have not changed so dramatically to outcome for this rapid rise, but our environment has the obesogenic environment

    *To begin with though, lets look at the reason why the obesogenic environment has become so important to study. Watch carefully how this slide changes colour over time particularly in AC. What you see is a doubling of the obesity rate in this region within 15 years as well as an overall trend across Canada for obesity rates to increase. Our lives become obesogenic. This shows the complexity of why the globe has been, and continues to increase in weight. It is COMPLEX! Notice a small areas of the map includes individual psychology, however that is where most of our intervention and prevention effort has been focused in the past.We need a new approach, and pregnancy is an ideal time to intervene with the potential to impact an entire life course, not just the mother but the child as well.Although urban/rural differences were found, it is clear that all of Nova Scotia is affected and there is great diversity.