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

ObjectivesTo assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).DesignRandomised controlled trial.SettingAntenatal clinic in England.ParticipantsWomen between 10+0and 14+6weeks gestation, not requiring specialist obstetric care.InterventionsParticipants were randomised to usual antenatal care or usual care (UC) plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.Primary and secondary outcome measuresExcessive gestational weight gain, depression, anxiety and physical activity.ResultsSix hundred and fifty-six women from four maternity centres were recruited: 329 women were randomised to the intervention group and 327 to UC. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation, the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted OR 0.84, 95% CI: 0.53 to 1.33) in the intervention and UC group, respectively. There were no significant difference between the groups in anxiety or depression scores (anxiety: adjusted mean −0.58, 95% CI:−1.25 to –0.8; depression: adjusted mean −0.60, 95% CI:−1.24 to –0.05). There were no significant differences in physical activity scores between the groups.ConclusionsA behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.Trial registration numberISRCTN67427351

Download Full-text

Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial

BMC Public Health ◽

10.1186/1471-2458-11-174 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 12

Author(s):

Cate Nagle ◽

Helen Skouteris ◽

Anne Hotchin ◽

Lauren Bruce ◽

Denise Patterson ◽

...

Keyword(s):

Weight Gain ◽

Randomised Controlled Trial ◽

Gestational Weight Gain ◽

Controlled Trial ◽

Obese Women ◽

Midwifery Care ◽

Gestational Weight ◽

Randomised Controlled

Download Full-text

The effects of a local dairy food supplement on pregnancy outcomes in Indonesia: A feasibility trial

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.924 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

H Soltani ◽

F Fair ◽

K Marvin-Dowle ◽

N I Lipoeto

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Randomised Controlled Trial ◽

Gestational Weight Gain ◽

Body Mass ◽

Controlled Trial ◽

Buffalo Milk ◽

Neonatal Health ◽

Gestational Weight ◽

Randomised Controlled

Abstract Introduction Approximately 20.1% of Indonesian pregnant women are underweight (BMI<18.5kg/m²) and over 50% of women have inadequate gestational weight gain (GWG) [1]. Maternal nutrition is a modifiable factor influencing child health. This project aims to assess the feasibility of a randomised controlled trial (RCT) using a traditional Indonesian yogurt from buffalo milk (Dadih), to improve outcomes for pregnant mothers and their babies. Methods This is a two armed feasibility RCT (1:1) in which 200 women with body mass index<27.5kg/m² (Asian BMI classifications) were planned to randomly be allocated to routine care or the intervention group, who will be supplemented with four weekly servings of Dadih. Results A total of 107 women were recruited to the trial in the first wave from Dec 2018-March 2019 (recruitment rate of ∼25/month). Of these 81 have been followed up to delivery and will be followed up to 6 months postpartum. Local Dadih production reached its full capacity in one region and recruitment had to be extended to other regions. Comparative trends on study outcomes including GWG, mode of birth, postpartum depression, postpartum haemorrhage, maternal nutritional status, anaemia, birthweight, gestational age, admission to neonatal care unit, breastfeeding, neonatal health status will be reported. Conclusions Early results show that the supplementation is acceptable to women and protocol implementation is feasible. In order for this feasibility project to be developed to a full scale RCT, improvements to the infrastructure of supply are required. Such projects may have positive economic impact and provide sustainable solutions to local maternal and neonatal health challenges. Reference 1. Soltani H, Lipoeto NI, Fair FJ, Kilner K, Yusrawati Y. (2017) Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Women's Health. Key messages Nutritional supplementation using a traditional Indonesian yogurt (Dadih) made from buffalo milk during pregnancy has been received positively by women. Depending on the observed comparative trends from the study outcomes, infrastructure investment is required to enable the feasibility study to be expanded to a full scale randomised controlled trial.

Download Full-text