April 3, 2008

Obese Pregnant Women Use More Health Care Services than Non-Obese Pregnant Women

Obesity during pregnancy is associated with greater use of health care services and longer hospital stays, according to a recent study from the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente Northwest Center for Health Research. The study, published in the April 3, 2008, issue of the New England Journal of Medicine, is the first to quantitatively document the effect of obesity during pregnancy on the use of health care services.

Using data from 13,442 pregnancies that resulted in a live birth or stillbirth between 2001 and 2004, researchers found that obese pregnant women had longer hospital stays, more obstetrical ultrasounds, used more outpatient medications, and were more likely to be seen by physicians than nurse midwives and nurse practitioners compared with their normal weight counterparts. The primary reasons for the increased utilization of these services were increases in cesarean section and obesity-related high risk conditions.

“These are very important findings for women who are thinking of having children, not just because of the increased costs of obesity and pregnancy, but also because of the increased health risks for mother and baby,” says Mark Hornbrook, PhD., an author on the study and chief scientist at the Kaiser Permanente Center for Health Research in Portland, Ore. “If obese women can lose weight before they become pregnant, it will help them avoid complicated and costly procedures during their pregnancies.”

To obtain a copy of the article, please call Gail Mathabane at 503-758-9024. For more information, see below.

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The latest in a series of studies

This study is the latest in a string of Kaiser Permanente research studies to help uncover the best approaches to women’s health before, during and after pregnancy.

  • A study in Diabetes Care in August 2007 showed the link between gestational diabetes during pregnancy and childhood obesity can be broken by treating diabetes during pregnancy.
  • A study in February 2008 in the Journal of American Medical Association showed that losing weight and keeping it off is possible if you have ongoing, long-term support.
  • A study in American Journal of Epidemiology in November showed that getting enough sleep – even just two hours more – may be as important as a healthy diet and exercise for new mothers to return to their pre-pregnancy weight. Mothers who slept five hours per day when babies were six months old had a threefold higher risk for substantial weight retention (11 pounds or more) at their baby’s first birthday than moms who slept seven hours per day.
  • A study in The American Journal of Psychiatry in September showed that more than one in seven women – 15.4 percent -- are identified as depressed at some time during the nine months before, during or after pregnancy.
  • A study nearing completion at the KP Division of Research that aims to find best way to help immediate post-partum women improve their diet/activity/ weight and used health coaches.

How Kaiser Permanente Helps Women Before and During Pregnancy

  • Research shows that losing weight and keeping it off is best achieved with support so KP offers dieticians for guidance on meal-planning, a weight maintenance newsletter with tips from clinical findings, research and patient sharing, an online Balance programs to keep people connected electronically and keep an eye on portion size
  • Also available are an email your doctor tool for quick answers to questions about weight management before and during pregnancy, a pregnancy e-newsletter with tips and techniques, an online health encyclopedia and other online programs, podcasts, videos, weight and exercise programs, and discounts for gym memberships and Weight Watchers enrollment
  • KP also offers classes for expectant fathers to teach them the basics of newborn care, warn them about post-partum depression and equip them on how to support new mothers during the transition of a baby’s first months at home

How Kaiser Permanente Helps Women Post-Pregnancy

  • Kaiser Permanente has integrated care for moms with care for babies so it’s easier for moms to adjust to postpartum life and get back into shape after having a baby
  • KP has an award-winning breast-feeding support program with lactation specialists who coach new moms through breast-feeding and discuss nutrition, which helps them lose pregnancy weight and prevent childhood obesity among babies
  • KP clinicians promote physical activity post-partum by encouraging new moms to walk frequently with the 10,000 Steps pedometer program, not watch too much TV, and to enroll in mother-baby classes where instructors teach mothers the habits for healthy eating and active living
  • New moms have access to newborn clubs, an online health encyclopedia and other online programs, podcasts, videos, weight and exercise programs, and discounts for gym memberships and Weight Watchers enrollment.

How Kaiser Permanente Promotes Obesity Prevention

  • KP supports 30 farmers markets at Kaiser Permanente medical centers in six states
  • A Healthy Picks Vending Machine Initiative
  • TV Turnoff Week
  • Healthy Eating Active Living programs in 27 communities across the US that makes it easier for people to choose healthy foods and get more active.
  • an Online Total Health assessment on kp.org to understand your personal risk for weight issues and help you develop an action plan for change

How KP HealthConnect Helps KP Doctors Help Their Patients Lose Weight

  • Doctors and nurses use HealthConnect to help track patients’ weight from visit to visit,
  • HealthConnect automatically calculates BMI and charts the weight and BMI data to share with members
  • HealthConnect issues detailed patient instructions on the After Visit Summary
  • Members can access information from previous office visits on kp.org
  • Through the secure online features, members can view weight and BMI and communicate with their providers; and providers can support their patients’ behavior changes through secure e-mail  

For more information contact:

Gail Mathabane, (503) 758-9024, Gail.Mathabane@kpchr.org or
Mary Sawyers, (503) 335-6602, Mary.A.Sawyers@kpchr.org



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