Quality standard

Quality statement 4: Risk assessment – body mass index

Quality statement

Pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment are offered personalised advice from an appropriately trained person on healthy eating and physical activity.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence of local arrangements to offer pregnant women the option to have their body mass index calculated and recorded at the booking appointment.

Data source: Local data collection.

b) Evidence of local arrangements to ensure that pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment are offered personalised advice from an appropriately trained person on healthy eating and physical activity.

Data source: Local data collection. The self-assessment tool for NICE's guideline on weight management before, during and after pregnancy.

Process

a) Proportion of pregnant women accessing antenatal care whose body mass index is calculated and recorded at the booking appointment.

Numerator – the number in the denominator whose body mass index is recorded at the booking appointment.

Denominator – the number of pregnant women accessing antenatal care.

Data source: The NHS Digital Maternity Services Data Set collects data on the BMI of the mother at booking. Areas may wish to consider setting a local target that reflects expectations that some women may decide not to have their body mass index calculated.

b) Proportion of pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment who are offered personalised advice from an appropriately trained person on healthy eating and physical activity.

Numerator – the number in the denominator offered personalised advice from an appropriately trained person on healthy eating and physical activity.

Denominator – the number of pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment.

Data source: Local data collection. The NHS Digital Maternity Services Data Set collects data on the BMI of the mother at booking.

Outcome

Women with a body mass index of 30 kg/m2 or more feel confident to make decisions about healthy eating and physical activity during their pregnancy.

Data source: Local data collection, for example, local survey.

What the quality statement means for different audiences

Service providers ensure that systems are in place to offer pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment personalised advice from an appropriately trained person on healthy eating and physical activity.

Healthcare professionals offer women with a body mass index of 30 kg/m2 or more at the booking appointment personalised advice on healthy eating and physical activity or, if they are not appropriately trained to do this, refer them to an appropriately trained person.

Commissioners ensure they commission services that offer pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment personalised advice from an appropriately trained person on healthy eating and physical activity.

Pregnant women with a body mass index of 30 kg/m 2 or more at the booking appointment are offered advice relevant to them from an appropriately trained person on healthy eating and physical activity.

Source guidance

Definitions of terms used in this quality statement

An appropriately trained person

Someone who can demonstrate expertise and competencies in weight management in pregnancy, including providing advice about nutrition and/or physical activity. This may include obstetricians, GPs, midwives, health visitors, nurses, dietitians, midwifery assistants, support workers and those working in weight management programmes (commercial or voluntary).

[Expert opinion]

Equality and diversity considerations

The body mass index threshold may need adapting for different groups of pregnant women (for example, women from certain ethnic groups). A body mass index measure is considered unsuitable for use with those under 18.