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

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.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.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.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

Age-specific prevalence of different combinations of high BMI, DM and hypertension among women of reproductive age (WRA) in the JHLS sample, 2007/8.

<p>Age-specific prevalence of different combinations of high BMI, DM and hypertension among women of reproductive age (WRA) in the JHLS sample, 2007/8.</p

Percentage distribution of socio-demographic and reproductive variables in women of reproductive age and in those with (and without) high BMI, diabetes and hypertension, JHLS 2007/8.

<p>Percentage distribution of socio-demographic and reproductive variables in women of reproductive age and in those with (and without) high BMI, diabetes and hypertension, JHLS 2007/8.</p

Maternal deaths among women classified as obese and otherwise, Jamaica maternal mortality surveillance database, 1998–2012.

<p>Maternal deaths among women classified as obese and otherwise, Jamaica maternal mortality surveillance database, 1998–2012.</p

Immediate (ICOD) and underlying (UCOD) cause of maternal deaths related to high BMI (overweight or obesity).

<p>Immediate (ICOD) and underlying (UCOD) cause of maternal deaths related to high BMI (overweight or obesity).</p