@rr_metabolicmed presents the Bruce Scott Lecture 2023 at #OAA23ASM: Obesity & diabetes in pregnancy - legacy for the child. #OBAnes 
Study of 1.3 million pregnant women reveals global obesity crisis: 75% pregnant women fail to achieve healthy weight gain during pregnancy, leading to preventable adverse health consequences for both the women and their babies. Obesity has strong evidence for increased risk of… twitter.com/i/web/status/1…
Maternal obesity and offspring cardiovascular disease: maternal obesity increases offspring cardiovascular death (Hazard ratio [all cause mortality] = 1.35). At current UK maternal obesity rates, this equates to extra 650 deaths before age 50 each year. The Hazard ratio for type… twitter.com/i/web/status/1…
Underlying mechanisms? Multiple intrauterine effects, shared environmental factors, shared genetics. On genetics: 60 loci, 15% birthweight variance. #OBAnes #OAA23ASM
Antenatal metabolic clinic allowed detailed characterization of >300 mothers & babies during pregnancy and postpartum. Cohort study of BMI > 40 vs BMI < 25, with follow up of children to age 4-5years. #OBAnes #OAA23ASM
Care of women with Obesity in Pregnancy. Multimodal, multidisciplinary and #OBAnes have a role to play. Bruce Scott was the only anaesthetist since James Young to be awarded Fellowship of the Edinburgh Society of Obstetricians for his work in epidural anaesthesia since Simpson… twitter.com/i/web/status/1…
High risk obese women who attend a multidisciplinary clinic have better outcomes: more likely to diagnose GDM; less likely to have LBW baby; lower risk of stillbirth (relative risk of stillbirth 8.14 among women not attending clinic). Multidisciplinary clinic allows platform for… twitter.com/i/web/status/1…
Embedded experimental medicine studies: maternal stressors, maternal physiology, and placental structure & function. Clinical trials have resulted - metformin in obese pregnancy; first trial of glibenclamide as alternative to insulin; CBT intervention for anxiety. #OBAnes… twitter.com/i/web/status/1…
Consequences of obesity in pregnancy for the child: developmental delay (was this controlled for in @Anaes_Journal neurodevelopmental outcomes study by Bleeser et al @noolslucas @DevroeSarah @MarcVandeVelde6 @rex_steffen? Adds an interesting dimension). Maternal BMI > 40 is… twitter.com/i/web/status/1…
Imaging the fetal brain in vivo. Brain development of fetuses of mothers with diabetes is statistically different. (Similar question for Bleeser et al; @DevroeSarah @noolslucas @MarcVandeVelde6 @rex_steffen, it may well have been but thinking aloud) #OBAnes #OAA23ASM
Media coverage - balanced? Pregnancy as an opportunity to improve population health? Intergenerational cycle of obesity - time to break the cycle? #OBAnes #OAA23ASM
Virtual pregnancy and child cohort (pandemic baby cohort) - virtual allows to reach hard to reach groups (@jaymcv @DrWesleyEdwards along the lines of other conversation on maternal care networks). New demographics and pregnancy challenges: increasing obesity rates; older mothers… twitter.com/i/web/status/1…
@rr_metabolicmed is recruiting. A lifecourse approach. A GLOBAL strategy would yield tremendous returns. Thank you’s and acknowledgements #OBAnes #OAA23ASM
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