Maternal health and early years June 2011 Maternal health and early years Insert name of presentation on Master Slide Presenter: Hilary Fielder

Public health evidence base 36, 000 births each year in Wales Teenage conception rate 44.3 per 1,000 22% smoking prevalence through out pregnancy 6.5% pregnant women obese (highest in UK) Lower levels of reading, maths, science in Welsh 15 year olds compared with England and Scotland Data from National Community Child Health Database – 36,000 births in 2010 Based on ONS data for 2008, the under 18 conception rate was higher in Wales at 44.3 compared to 40.5 per 1,000 women in England. However within England rates vary by region and Wales has rates that are comparable to the North West, West Midlands and London. Rates also vary between local authority areas and some of this is attributed to variation in population and socio-economic characteristics within the country. Over the last four years preterm birth rates have remained steady at 60-65 per 1,000 births, but inequalities have persisted with rates consistently higher in the least deprived quintile of social deprivation compared with the most deprived Data from the Infant feeding survey in 2005 - overall smoking prevalence throughout pregnancy in Wales was 22%, extrapolating this to the annual number of births we have 7,700 babies each year that are exposed to cigarette smoking during pregnancy CEMACE 2010 report - Wales has the highest prevalence of obesity in pregnancy in the UK, 6.5% of pregnant women in Wales have a BMI OF 35 or higher. Health Behaviour in School aged children survey – Wales has highest UK rates for smoking and obesity PISA 2009 repor - three-yearly survey of 15-year-olds in the 30 OECD member countries and 35 partner countries shows lower levels of reading, maths and science compared withScotland.

Obesity Pre-eclampsia RR 3 Gest diabetes RR 3 Thromboembolism OR 2.6 Baby Mother Pre-eclampsia RR 3 Gest diabetes RR 3 Thromboembolism OR 2.6 Post partum haemorhage RR 4 Stillbirth RR 2 Preterm birth RR 1.2 Intensive care RR 1.5 Large for gestational age RR 2 For the mother, obesity is associated with pre-eclampsia, gestational diabetes, thromboembolism, caesarean section, infection and post-partum heamorrhage. For the baby obesity is associated with stillbirth, neonatal death, congenital anomalies, preterm birth, and increased risk of obesity and metabolic disorders in childhood. No data on diet, healthy eating Obesity and metabolic disorders in childhood Source: CEMACE

Teenage pregnancies

Teenage pregnancy Pre-term birth OR 1.2 – 1.9 Low birth weight Baby at increased risk of Pre-term birth OR 1.2 – 1.9 Low birth weight OR 1.2 – 1.8 Neonatal mortality OR 1.3 – 2.7 Harm, illness, injuries Behavioural and emotional complications 2 X more likely to have a teen birth We looked at the evidence on the impact of teenage pregnancy a couple of years ago in a review that was published in the Rchives of Diseases in Childhood. We found that compared to older mothers, babies born to teenage mothers were up to two times more likely to be born pre-term, or low birth weight, nearly three times more likely to be dead within the first 28 days of life, have increased risk of harm, illness, injuries, behavioural and emotional complications; and they are also twice as likely to go on to have a teenage pregnancy themselves, compared to children that are born to older mothers. icable. The questions we were really trying to answer are: Is young maternal age on its own a risk for poor health outcomes? Or Is the increased risk attributable to the socio-economic circumstances leading to and following pregnancy in this group. Source: Paranjothy et al Arch Dis Child 2009 94: 239-245

Next phase Development of Reproductive and Early Years Surveillance Programme Completion of evidence synthesis work Mapping evidence and programmes in place Epidemiological modelling of impact of exposures and interventions Link to healthcare quality in maternity and child health services including 1,000 live plus Communication and engagement with policy, healthcare professionals and public A workshop was held on the 1st of April to consider the findings of the pathfinder phase and concluded PHW can play a major part in coordinating the health components and linkages to wider policy issues. This second phase of the Reproductive and Early Years project is currently being scoped - and will cover these workstreams   Our Healthy Future?