Extra costs for care of obese pregnant patients

Under strict embargo until 12.01am Friday October 16, 2015

Hospitals face extra costs for care of obese pregnant patients

Hospitals across Australia and New Zealand are facing increased time and cost burdens in caring for obese pregnant women giving birth by caesarean section, new research indicates.

The research, one of the first studies of its kind, found that with every obese and very obese pregnant woman undergoing a caesarean section, hospitals experienced an average increased anaesthesia time of between of eight to 18 minutes or 10 to 25 per cent.

This amounted to extra costs of $25 per minute for hospitals, a figure that has not previously been calculated.

The MUM SIZE study examined the time under anaesthesia care for about 1500 women undergoing caesarean section and the interaction between a mother’s size and time in the operating room for caesarean delivery.

Lead investigator Professor David Story, Chair of Anaesthesia at the University of Melbourne and a Fellow of the Australian and New Zealand College of Anaesthetists (ANZCA), said the study’s fundamental aim was to increase understanding of the best ways to care and plan for women giving birth by caesarean, in both metropolitan and regional areas. The research received seed funding through ANZCA’s Anaesthesia and Pain Medicine Foundation.

The average length of time under the care of anaesthetists (before during and after delivery) for a pregnant woman of normal weight undergoing a caesarean is about 72 minutes, Professor Story said.

For obese women (BMI 35-45) there was a 10 per cent increase in times.

For the very obese (BMI of 45 and over), there is a 25 per cent increase in time under the care of an anaesthetist.

The obese and very obese group made up 28 per cent, or almost one-third, of all the women in the study.

The data were collected by maternity units at seven Victorian hospitals but Professor Story said that while there will be regional differences these figures are likely to represent public hospitals across Australia and New Zealand. Further, increased operating room times are likely to be associated with caring for obese patients undergoing other types of surgery.

“Maternal obesity is associated with increased hospital care and has important operating room planning and resource implications for hospitals with maternity services.

“Women with increased body size are more likely to have a caesarean delivery.”

The results of the study have been released to coincide with National Anaesthesia Day, an initiative of the Australian and New Zealand College of Anaesthetists.

The theme of National Anaesthesia Day 2015 is “Obesity complicates anaesthesia”.

It is estimated that close to one out of every three people across Australia and New Zealand is obese and an increasing number of this group is severely and morbidly obese. This group faces an increased risk of complications when they need an anaesthetic for an operation.

National Anaesthesia Day encourages people with excess weight, who are anticipating anaesthesia as part of any medical procedure, to speak to their medical team, including their anaesthetist, to discuss ways to reduce their risk.

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