Intervention during pregnancy to reduce excessive gestational weight gain—a randomised controlled trial

Abstract

Objective To evaluate if a feasible, low-cost intervention could decrease the percentage of women gaining weight above the Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) compared with standard maternity care.Design A randomised controlled interventional design.Setting Antenatal clinics (n = 14) in Ö rebro county, Sweden, participated.Population Healthy women with a body mass index (BMI) ≥19 kg/m 2 , age ≥18 years and adequate knowledge of Swedish language who signed in for maternity care at ≤16 weeks of gestation.Methods Standard care was compared with a composite intervention consisting of education on recommended GWG according to IOM, application of personalised weight graph, formalised prescription of exercise and regular monitoring of GWG at every antenatal visit.Outcome The proportion of women gaining weight above IOM guidelines (1990) and mean GWG (kg) was compared between groups.Results In all, 445 women were randomised and 374 women remained for analysis after delivery. A majority of the women analysed were normal weight (72%). The intervention reduced the proportion of women who exceeded the IOM guidelines (41.1% versus 50.0%). The reduction was, however, not statistically significant (P = 0.086). Mean GWG was significantly lower among women receiving the intervention, 14.2 kg (SD 4.4) versus 15.3 kg (SD 5.4) in the standard care group (P = 0.029).Conclusions The low-cost intervention programme tested did significantly reduce the mean GWG but the proportion of women who exceeded the IOM recommendations for GWG was not significantly lower. ClinicalTrials.gov Id NCT00451425 http://clinicaltrials.gov Keywords Gestational weight gain, maternal health, pregnancy, prevention of obesity.Please cite this paper as: Ronnberg AK, Ostlund I, Fadl H, Gottvall T, Nilsson K. Intervention during pregnancy to reduce excessive gestational weight gain-a randomised controlled trial. BJOG 2015;122:537-544.

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

“…67686970717273747576777879808182838485868788 A further 45 trials (9945 women)8990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133 were identified after the IPD acquisition timeline until February 2017.…”

Can antenatal diet and lifestyle interventions influence childhood obesity? A systematic review

“…The total sample size for the antenatal interventions was 3,988, which varied by study from 118 to 1,555. All interventions were conducted in high‐income countries: Denmark (Vinter, Jensen, Ovesen, Beck‐Nielsen, & Jorgensen, ), Finland (Kinnunen et al, ; Luoto et al, ), Germany (Rauh et al, ), Ireland (Walsh, McGowan, Mahony, Foley, & McAuliffe, ), Sweden (Ronnberg, Ostlund, Fadl, Gottvall, & Nilsson, ), United Kingdom (Poston et al, ), and United States (Vesco et al, ). Six trials included a combined dietary and physical activity intervention approach.…”

Human supraphysiological gestational weight gain and fetoplacental vascular dysfunction

“…However, a group of women showing normal body mass index (BMI) before they get pregnant (i.e., pre-pregnancy) or at early stages of pregnancy courses with a supraphysiological gestational weight gain (spGWG) ending pregnancy with obesity (BMI ≥30 kg/m 2 ). [3][4][5] According with the 2009 US Institute of Medicine (IOM) guidelines for GWG in women with normal pre-pregnancy BMI, 6 pregnant women showing a total weight gain (tWG) 11.5-16 kg and rates of weight gain (rWG) for the 2 nd and 3 rd trimester of pregnancy ≤0.42 kg/week correspond to pGWG, and those with tWG >16 kg and rWG >0.42 kg/week, correspond to spGWG. During pregnancy is crucial to maintain a pGWG to ensure appropriate fetus development and growth.…”