Perinatal Outcomes in Nutritionally Monitored Obese Pregnant Women: A Randomized Clinical Trial

Thornton, Yvonne S.; Smarkola, Claudia; Kopacz, Sharon M.; Ishoof, Sabriya B.

doi:10.1016/s0027-9684(15)30942-1

Cited by 150 publications

(284 citation statements)

References 27 publications

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“…A recent systematic review assessed the role of complex interventions in limiting gestational weight gain or reducing the risk of macrosomia (11) . There was significant heterogeneity across the studies related to the intensity of the intervention provided, ranging from additional dietetic sessions at each antenatal visit (44,45) to a single dietetic visit at the start of pregnancy (46) , making direct comparisons between studies difficult. However, the review found no statistically significant differences between women who received the antenatal intervention and those who did not for mean gestational weight gain (four studies; 416 women; weighted mean difference 3 .…”

Section: Complex Interventionsmentioning

confidence: 99%

Improving pregnancy outcome in obese women

Denison

Chiswick

2011

Proc. Nutr. Soc.

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The global pandemic of maternal obesity presents a major challenge for healthcare providers, and has significant short- and long-term implications for both maternal and fetal health. Currently, the evidence-base underpinning many of the interventions either currently in use or recommended to improve pregnancy outcome in obese women is limited. The nature and timing of these interventions vary widely, ranging from simple advice to more intensive dietary and exercise programmes, cognitive behavioural therapy and drug trials. In addition, a growing number of very severely obese women now enter pregnancy having had surgical interventions. Although surgical interventions such as gastric bypass or banding may be associated with improved pregnancy outcomes, these women have particular nutritional requirements, which need to be addressed to optimise pregnancy outcome. Until the outcomes of ongoing current trials are reported and provide a firm evidence base on which to base future intervention strategies and guide evidence based care for obese pregnant women, pregnancy outcome is best optimised by high-risk antenatal care delivered by healthcare providers who are experienced in supporting these high-risk women.

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Section: Complex Interventionsmentioning

confidence: 99%

Improving pregnancy outcome in obese women

Denison

Chiswick

2011

Proc. Nutr. Soc.

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“…Only one study (Thornton 2009) reported on postpartum complication outcomes such as postpartum haemorrhage, wound infection, endometritis, need for antibiotics, perineal trauma, thromboembolic disease, or maternal death.…”

Section: Objectivesmentioning

confidence: 99%

“…Studies recruiting women in high-risk groups: there were differences in the prepregnancy weight of women recruited to studies; only women who were overweight or obese were recruited in studies by Guelinckx 2010;Quinlivan 2011;Santos 2005;Thornton 2009;Wolff 2008; women who were either considered overweight or appeared to be gaining excessive weight in early pregnancy were recruited by Boileau 1968 andSilverman 1971. Women with or at high risk of gestational diabetes were included in four studies (Korpi-Hyovalti 2011;Luoto 2011;Moses 2009;Rae 2000) A mix of underweight, normal, overweight, and obese women were included in studies by Jeffries 2009;Phelan 2011;Polley 2002;Vitolo 2011 with separate results provided for women in the overweight/obese groups.…”

Section: Objectivesmentioning

confidence: 99%

“…• alternative interventions compared (brochure plus counselling versus brochure alone (Guelinckx 2010); high versus low glycaemic diet (Moses 2009); energy restricted diabetic diet versus non-energy restricted diabetic diet (Rae 2000); low glycaemic load versus low fat diet ; aerobic exercise plus relaxation versus relaxation alone (Santos 2005); nutritional counselling and weight monitoring versus nutritional counselling alone (Thornton 2009)). …”

Section: Objectivesmentioning

confidence: 99%

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Interventions for preventing excessive weight gain during pregnancy

Muktabhant

Lumbiganon

Ngamjarus

2008

Cochrane Database of Systematic Reviews

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“…Recent studies show that some of these risks are averted if a woman's pregnancy weight gain is restricted [15][16][17] . Few studies have provided quantitative estimations of the related increase in the use of health care services for obese pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women

et al. 2011

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Method:In total 155 women in an intervention group attempted to restrict gestational weight gain to less than 7 kg. The control group was comprised of 193 women.Mean costs during pregnancy, delivery and the neonatal period were compared with costs of standard care. Costs converted from Swedish Crowns (SEK) to EURO. Results:The health care cost during pregnancy was lower in the intervention group.There was no significant difference in total health care costs; that is, the sum of costs during pregnancy, delivery and the neonatal period between the intervention group and the control group. Within the intervention group the subgroup that gained 4.5 -9.5 kg had the lowest costs. The total cost, including the intervention costs, was EURO 1283 more per woman/infant in the intervention group compared to the control group (p=0.025). The degree of obesity at inclusion to the program had no bearing on the outcome. Conclusions:The weight gain restriction program for obese pregnant women was effective in restricting gestational weight gain to less than 7 kg but had a higher total cost compared to the control group.

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Perinatal Outcomes in Nutritionally Monitored Obese Pregnant Women: A Randomized Clinical Trial

Cited by 150 publications

References 27 publications

Improving pregnancy outcome in obese women

Improving pregnancy outcome in obese women

Interventions for preventing excessive weight gain during pregnancy

Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women

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