The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica

Lovney Kanguru; Affette McCaw-Binns; Jacqueline Bell; Novie Yonger-Coleman; Rainford Wilks; Julia Hussein

doi:10.1371/journal.pone.0188677

The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica

Lovney Kanguru, Affette McCaw-Binns, Jacqueline Bell, Novie Yonger-Coleman, Rainford Wilks, Julia Hussein

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death.

MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities. A national maternal mortality surveillance database (1998-2012) of 798 maternal deaths was used to investigate maternal deaths in obese women. Chi-squared and Fisher exact tests were used.

RESULTS: High BMI (> = 25kg/m2) occurred in 63% of women aged between 15 and 49 years. It was associated with increasing age, high gravidity and parity, and full time employment (p<0.001). Of those with high BMI, 5.5% were diabetic, 19.3% hypertensive and 2.8% were both diabetic and hypertensive. Obesity was recorded in 10.5% of maternal deaths, with higher proportions of deaths due to hypertension in pregnancy (27.5%), circulatory/ cardiovascular disorders (13.0%), and diabetes (4.3%) compared to 21.9%, 6.9% and 2.6% respectively in non-obese women.

CONCLUSIONS: This is one of a few studies from a middle-income setting to explore maternal burden of obesity during pregnancy, which contributes to improving the knowledge base, identifying the gaps in information and increasing awareness of the growing problem of maternal overweight and obesity. While survey diagnostic conditions require cautious interpretation of findings, it is clear that obesity and related medical conditions present a substantial public health problem for emerging LMICs like Jamaica. There is an urgent need for global consensus on routine measures of the burden and risk factors associated with obesity and development of culturally appropriate interventions.

Original language	English
Pages (from-to)	e0188677
Journal	PLoS ONE
Volume	12
Issue number	12
DOIs	https://doi.org/10.1371/journal.pone.0188677
Publication status	Published - 13 Dec 2017

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10.1371/journal.pone.0188677

The burden of obesity...
Copyright: © 2017 Kanguru et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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title = "The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica",

abstract = "INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death.MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities. A national maternal mortality surveillance database (1998-2012) of 798 maternal deaths was used to investigate maternal deaths in obese women. Chi-squared and Fisher exact tests were used.RESULTS: High BMI (> = 25kg/m2) occurred in 63% of women aged between 15 and 49 years. It was associated with increasing age, high gravidity and parity, and full time employment (p<0.001). Of those with high BMI, 5.5% were diabetic, 19.3% hypertensive and 2.8% were both diabetic and hypertensive. Obesity was recorded in 10.5% of maternal deaths, with higher proportions of deaths due to hypertension in pregnancy (27.5%), circulatory/ cardiovascular disorders (13.0%), and diabetes (4.3%) compared to 21.9%, 6.9% and 2.6% respectively in non-obese women.CONCLUSIONS: This is one of a few studies from a middle-income setting to explore maternal burden of obesity during pregnancy, which contributes to improving the knowledge base, identifying the gaps in information and increasing awareness of the growing problem of maternal overweight and obesity. While survey diagnostic conditions require cautious interpretation of findings, it is clear that obesity and related medical conditions present a substantial public health problem for emerging LMICs like Jamaica. There is an urgent need for global consensus on routine measures of the burden and risk factors associated with obesity and development of culturally appropriate interventions.",

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N2 - INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death.MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities. A national maternal mortality surveillance database (1998-2012) of 798 maternal deaths was used to investigate maternal deaths in obese women. Chi-squared and Fisher exact tests were used.RESULTS: High BMI (> = 25kg/m2) occurred in 63% of women aged between 15 and 49 years. It was associated with increasing age, high gravidity and parity, and full time employment (p<0.001). Of those with high BMI, 5.5% were diabetic, 19.3% hypertensive and 2.8% were both diabetic and hypertensive. Obesity was recorded in 10.5% of maternal deaths, with higher proportions of deaths due to hypertension in pregnancy (27.5%), circulatory/ cardiovascular disorders (13.0%), and diabetes (4.3%) compared to 21.9%, 6.9% and 2.6% respectively in non-obese women.CONCLUSIONS: This is one of a few studies from a middle-income setting to explore maternal burden of obesity during pregnancy, which contributes to improving the knowledge base, identifying the gaps in information and increasing awareness of the growing problem of maternal overweight and obesity. While survey diagnostic conditions require cautious interpretation of findings, it is clear that obesity and related medical conditions present a substantial public health problem for emerging LMICs like Jamaica. There is an urgent need for global consensus on routine measures of the burden and risk factors associated with obesity and development of culturally appropriate interventions.

AB - INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death.MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities. A national maternal mortality surveillance database (1998-2012) of 798 maternal deaths was used to investigate maternal deaths in obese women. Chi-squared and Fisher exact tests were used.RESULTS: High BMI (> = 25kg/m2) occurred in 63% of women aged between 15 and 49 years. It was associated with increasing age, high gravidity and parity, and full time employment (p<0.001). Of those with high BMI, 5.5% were diabetic, 19.3% hypertensive and 2.8% were both diabetic and hypertensive. Obesity was recorded in 10.5% of maternal deaths, with higher proportions of deaths due to hypertension in pregnancy (27.5%), circulatory/ cardiovascular disorders (13.0%), and diabetes (4.3%) compared to 21.9%, 6.9% and 2.6% respectively in non-obese women.CONCLUSIONS: This is one of a few studies from a middle-income setting to explore maternal burden of obesity during pregnancy, which contributes to improving the knowledge base, identifying the gaps in information and increasing awareness of the growing problem of maternal overweight and obesity. While survey diagnostic conditions require cautious interpretation of findings, it is clear that obesity and related medical conditions present a substantial public health problem for emerging LMICs like Jamaica. There is an urgent need for global consensus on routine measures of the burden and risk factors associated with obesity and development of culturally appropriate interventions.

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The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica

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