A behavioural nutrition intervention for obese pregnant women: Effects on diet quality, weight gain and the incidence of gestational diabetes

Abstract

Background: Obese pregnant women have an increased risk of antenatal, intra-and post-partum complications. At present, there is limited evidence to support specific nutritional management of obese women in pregnancy, and guidelines are infrequently translated into practice. Aims: To implement an individually tailored nutrition program for obese pregnant women to reduce the rates of gestational diabetes mellitus (GDM), improve diet quality, achieve weight gain targets, limit gestational weight gain (GWG) and reduce complications for mother and child. Methods: A prospective dietary intervention study was conducted at a hospital in Melbourne, Australia, using a parallel control group from the Birthing Outcomes System (BOS) database. Obese pregnant women were included if they were ≤21 weeks gestation and aged ≥18 years. The intervention group received one face-to-face dietitian-delivered consultation, with reviews conducted over the phone. Results: A total of 92 and 125 obese pregnant women were enrolled into the dietary intervention group and BOS control group, respectively. The diet quality of intervention participants improved, without significant differences in GWG across groups. In the control group, 19.3% of women developed GDM, compared to 6.5% in the diet group (P 0.013). However, after adjusting for ethnicity and body mass index, the association between the diet group and GDM incidence was no longer significant. Conclusions: This study demonstrates that a behavioural nutrition intervention, individually tailored for obese pregnant women can improve diet quality. A larger randomised controlled trial targeted at obese pregnant women, with comparable groups at baseline, is required to observe the effects of dietary improvement on GDM incidence, and other maternal and neonatal outcomes.

Estimated global overweight and obesity burden in pregnant women based on panel data model

“…Dietary interventions and physical activity interventions were recommended to limit GWG and prevent GDM in overweight and obese pregnant women [ 49 , 50 , 51 ]. However, a randomised controlled trail in UK found that dietary and physical interventions in pregnant women with obesity were not adequate to prevent GDM or large-for-gestational-age infants, and a recent study in Australia also reported no significant differences in GDM between the behavioural nutrition intervention group and the control group after adjusting confounding factors [ 52 , 53 ]. From a public health perspective, it is a cost-effective strategy to control the prevalence of obesity among women of childbearing age.…”

The combination of symphysis-fundal height and abdominal circumference as a novel predictor of macrosomia in GDM and normal pregnancy

“…Study group was divided into GDM and NP by OGTT. If a patient develops GDM, the intervention began, such as physical activity and dietary behavioral intervention [14]. To improve the accuracy of these parameters, repeated measurement was performed by averaging the testing values.…”

ISFHAC as a novel predictor of macrosomia in gestational diabetes mellitus and normal pregnancy

“…This process, together with all other aspects of the study, was approved by the Research Ethics Committee of Wuhan University. Women ≥ 16 years of age and with a singleton pregnancy with or without GDM were randomized to either standard antenatal care or physical activity and dietary behavioral intervention superimposed on standard antenatal care [13].…”