scholarly journals Implementation of the Living Well During Pregnancy Telecoaching Program for Women at High Risk of Excessive Gestational Weight Gain: Protocol for an Effectiveness-Implementation Hybrid Study

10.2196/27196 ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. e27196
Author(s):  
Susan de Jersey ◽  
Nina Meloncelli ◽  
Taylor Guthrie ◽  
Hilary Powlesland ◽  
Leonie Callaway ◽  
...  
Keyword(s):  
Weight Gain ◽  
Antenatal Care ◽  
Gestational Weight Gain ◽  
Program Implementation ◽  
Health Service Delivery ◽  
Control Group ◽  
Dietary Counseling ◽  
Gestational Weight ◽  
Living Well ◽  
Routine Antenatal Care

Background Despite comprehensive guidelines for healthy gestational weight gain (GWG) and evidence for the efficacy of dietary counseling coupled with weight monitoring on reducing excessive GWG, reporting on the effectiveness of interventions translated into routine antenatal care is limited. Objective This study aims to implement and evaluate the Living Well during Pregnancy (LWdP) program in a large Australian antenatal care setting. Specifically, the LWdP program will be incorporated into usual care and delivered to a population of pregnant women at risk of excessive GWG through a dietitian-delivered telephone coaching service. Methods Metrics from the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework will guide the evaluation in this hybrid effectiveness-implementation study. All women aged ≥16 years without pre-exiting diabetes with a prepregnancy BMI >25 kg/m2 and gaining weight above recommendations at <20 weeks’ gestation who are referred for dietetic care during the 12-month study period will be eligible for participation. The setting is a metropolitan hospital at which approximately 6% of the national births in Australia take place each year. Eligible participants will receive up to 10 telecoaching calls during their pregnancy. Primary outcomes will be service level indicators of reach, adoption, and implementation that will be compared with a retrospective control group, and secondary effectiveness outcomes will be participant-reported anthropometric and behavioral outcomes; all outcomes will be assessed pre- and postprogram completion. Additional secondary outcomes relate to the costs associated with program implementation and pregnancy outcomes gathered through routine clinical service data. Results Data collection of all variables was completed in December 2020, with results expected to be published by the end of 2021. Conclusions This study will evaluate the implementation of an evidence-based intervention into routine health service delivery and will provide the practice-based evidence needed to inform decisions about its incorporation into routine antenatal care. International Registered Report Identifier (IRRID) DERR1-10.2196/27196

scholarly journals Living Well during Pregnancy: Protocol for the implementation of a tele-coaching healthy lifestyle program for women at high risk of excess gestational weight gain (Preprint)

2021 ◽  
Author(s):  
Susan de Jersey ◽  
Nina Meloncelli ◽  
Taylor Guthrie ◽  
Hilary Powlesland ◽  
Leonie Callaway ◽  
...  
Keyword(s):  
Weight Gain ◽  
Antenatal Care ◽  
Gestational Weight Gain ◽  
Program Implementation ◽  
Healthy Lifestyle ◽  
Health Service Delivery ◽  
Control Group ◽  
Gestational Weight ◽  
Living Well ◽  
Routine Antenatal Care

BACKGROUND Despite comprehensive guidelines for healthy gestational weight gain (GWG) and evidence for the efficacy of dietary counselling coupled with weight monitoring, reporting on the effectiveness of interventions into routine antenatal care is limited. OBJECTIVE This study aims to implement and evaluate the Living Well during Pregnancy (LWdP) program in a large, Australian antenatal care setting. Specifically, LWdP will be incorporated into usual care and will be delivered to a population of pregnant women at risk of excessive GWG through a dietitian-delivered telephone coaching service. METHODS Metrics from the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation in this hybrid effectiveness-implementation study. All women aged ≥16 years, without pre-exiting diabetes with a pre-pregnancy BMI > 25kg/m2 or a pre-pregnancy BMI<25kgm2 and gaining weight above recommendations at <20 weeks gestation referred for dietetic care during the 12 month study period will be eligible for participation. The setting is a metropolitan hospital that has approximately 6% of the national births per year. Eligible participants will receive up to 10 tele-coaching calls during their pregnancy. Primary outcomes are service level indicators of reach, adoption, and implementation which will be compared to a retrospective control group, with secondary effectiveness outcomes of participant reported anthropometric and behavioural outcomes assessed at pre and post program completion. Additional secondary outcomes relate to the costs associated with program implementation and pregnancy outcomes gathered through routine clinical service data. RESULTS Data collection will be completed at the end of 2020, with results expected to be published by the end of 2021. CONCLUSIONS This study evaluating the implementation of an evidence-based intervention into routine health service delivery will provide the practice-based evidence needed to inform decisions about its incorporation into routine antenatal care.

scholarly journals Effect of gestational Mediterranean diet intervention on newborn fat mass and cord blood leptin level

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Rania Mohamed Abdou ◽  
Gehan Sayed El Hawary ◽  
Azza A. Saab
Keyword(s):  
Weight Gain ◽  
Mediterranean Diet ◽  
Gestational Weight Gain ◽  
Fat Mass ◽  
Intervention Group ◽  
Control Group ◽  
Dietary Counseling ◽  
Diet Intervention ◽  
Gestational Weight ◽  
The Impact

Abstract Background Maternal nutritional status is an important determinant of intrauterine growth and neonatal size. No published surveys exist on maternal Mediterranean diet intakes and newborn adiposity. The aim of the study was to evaluate the impact of the individual maternal Mediterranean diet on the in-utero body fat formation and cord leptin level in newborns. Pregnant women with a pre-pregnancy body mass index (BMI) between 30 and 35 kg/m2 (n = 118) were assisted for individual dietary counseling based on the Mediterranean diet healthy eating. According to diet adherence, participants (paired mother and newborn) were divided into an intervention group (n = 57) and a control group (n = 61). We examined the association between diet modification and gestational weight gain, maternal, and cord leptin level together with newborn anthropometry (weight and fat mass %). Results Gestational weight gain, newborn birth weight, fat mass %, and cord leptin level lower in the intervention (12.22 ± 1.8 kg, 3.57 ± 0.35 kg, 9.27 ± 2.16 %, 11.78 ± 3.63 ng/ml, p = 000, respectively) than in control group (18.03 ± 3.25 kg, 4.02 ± 0.32 kg, 11.85 ± 2.30 %, 35.37 ± 11.14 ng/ml, respectively. Umbilical cord leptin levels strongly correlated with neonatal fat mass percent in both groups. However, maternal serum leptin did not correlate with the newborn parameters in the intervention group. Conclusion Maternal energy intake from healthy fat and diet intervention is probably associated with decreased fat mass and leptin levels in neonates.

scholarly journals Lower education predicts poor response to dietary intervention in pregnancy, regardless of neighbourhood affluence: secondary analysis from the ROLO randomised control trial

2017 ◽  
Vol 20 (16) ◽  
pp. 2959-2969 ◽  
Author(s):  
Eileen C O’Brien ◽  
Goiuri Alberdi ◽  
Aisling A Geraghty ◽  
Fionnuala M McAuliffe
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Dietary Intervention ◽  
Randomised Control Trial ◽  
Control Group ◽  
Education Session ◽  
Neighbourhood Deprivation ◽  
Gestational Weight ◽  
Dietary Education ◽  
In Pregnancy

AbstractObjectiveTo determine if response to a low glycaemic index (GI) dietary intervention, measured by changes in dietary intake and gestational weight gain, differed across women of varying socio-economic status (SES).DesignSecondary data analysis of the ROLO randomised control trial. The intervention consisted of a two-hour low-GI dietary education session in early pregnancy. Change in GI was measured using 3 d food diaries pre- and post-intervention. Gestational weight gain was categorised as per the 2009 Institute of Medicine guidelines. SES was measured using education and neighbourhood deprivation.SettingThe National Maternity Hospital, Dublin, Ireland.SubjectsWomen (n 625) recruited to the ROLO randomised control trial.ResultsThe intervention significantly reduced GI and excess gestational weight gain (EGWG) among women with third level education residing in both disadvantaged (GI, mean (sd), intervention v. control: −3·30 (5·15) v. −0·32 (4·22), P=0·024; EGWG, n (%), intervention v. control: 7 (33·6) v. 22 (67·9); P=0·022) and advantaged areas (GI: −1·13 (3·88) v. 0·06 (3·75), P=0·020; EGWG: 41 (34·1) v. 58 (52·6); P=0·006). Neither GI nor gestational weight gain differed between the intervention and control group among women with less than third level education, regardless of neighbourhood deprivation.ConclusionsA single dietary education session was not effective in reducing GI or gestational weight gain among less educated women. Multifaceted, appropriate and practical approaches are required in pregnancy interventions to improve pregnancy outcomes for less educated women.

scholarly journals Effect of Behavioural Interventions for Obesity Prevention in Pregnancy on the Adequacy of Gestational Weight Gain and Retention: Metabolic Health of Indian Women

2020 ◽  
Vol 21 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Alka Pawalia ◽  
Sivachidambaram Кulandaivelan ◽  
Satya Savant ◽  
Vikram Singh Yadav
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Diet Group ◽  
Control Group ◽  
Weight Retention ◽  
Indian Women ◽  
Behavioural Interventions ◽  
Gestational Weight ◽  
Supervised Exercise

AbstractThe aim of this study was to measure the adequacy of gestational weight gain (GWG) in Indian women using various behavioural interventions during pregnancy, which primarily aim to observe the effects on obesity markers and weight retention.In this experimental study, one hundred and forty pregnant women underwent interventions in 5 groups, control (C), diet (D), home exercise (HE), supervised exercise (SE) and supervised exercise with diet (SED), from pregnancy through delivery with 2 months follow-up post-delivery. The outcome measures were GWG and baby birth weight.A one-way ANOVA indicated no differences in the mean GWG between groups (12.39±4.71 kg, p=0.947). The control group had the most (50%) and both the supervised exercise groups had the fewest (32%) women who gained above the recommended GWG, followed by the diet group (33.3%). The D and HE groups had the most women who gained within the GWG range, while both the SE and SED groups had the most women who gained below the GWG range. However, these results did not affect the birth weight between the groups (mean 2.96 kg±0.40, p=0.203). In women with normal BMIs, (18.5-22.9 kg/m2), the diet group had the most effective maintenance of adequate GWG, with 15%, 55%, and 30% of the women gaining above, within, and below the recommended GWG, respectively. The SE and SED groups had the least postpartum weight retention (PPWR) at 2 months, followed by the HM, D and C groups; i.e., the results showed a trend in the desired direction clinically, although they were not statistically significant (p=0.12).Supervised exercise can be effectively used as a pregnancy intervention to prevent excess GWG in Indian women. Diet counselling was found to be the next best intervention in combination with exercise, as well as for women with normal BMI.

Maternal gestational weight gain during pregnancy: prioritising the conversation

2018 ◽  
Vol 24 (1) ◽  
pp. 4 ◽  
Author(s):  
Ruth Walker ◽  
Danielle Mazza ◽  
Michelle Blumfield ◽  
Christie Bennett ◽  
Helen Truby
Keyword(s):  
Primary Care ◽  
Weight Gain ◽  
Antenatal Care ◽  
Gestational Weight Gain ◽  
Health Professionals ◽  
Overweight And Obesity ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Care Guidelines ◽  
Weight Gain During Pregnancy

Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that women are supported to manage their weight during pregnancy.

scholarly journals Leptin and Ghrelin in Excessive Gestational Weight Gain—Association between Mothers and Offspring

2019 ◽  
Vol 20 (10) ◽  
pp. 2398 ◽  
Author(s):  
Jolanta Patro-Małysza ◽  
Marcin Trojnar ◽  
Katarzyna E. Skórzyńska-Dziduszko ◽  
Żaneta Kimber-Trojnar ◽  
Dorota Darmochwał-Kolarz ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Body Length ◽  
Head Circumference ◽  
Maternal Serum ◽  
Control Group ◽  
Gestational Weight ◽  
Neonatal Birth Weight ◽  
Serum Ghrelin

Two-thirds of pregnant women exceed gestational weight gain recommendations. Excessive gestational weight gain (EGWG) appears to be associated with offspring’s complications induced by mechanisms that are still unclear. The aim of this study was to investigate whether umbilical cord leptin (UCL) and ghrelin (UCG) concentrations are altered in full-term neonates born to EGWG mothers and whether neonatal anthropometric measurements correlate with UCL and UCG levels and maternal serum ghrelin and leptin as well as urine ghrelin concentrations. The study subjects were divided into two groups, 28 healthy controls and 38 patients with EGWG. Lower UCL and UCG levels were observed in neonates born to healthy mothers but only in male newborns. In the control group UCG concentrations correlated positively with neonatal birth weight, body length and head circumference. In the control group maternal serum ghrelin levels correlated negatively with neonatal birth weight, body length and head circumference as well as positively with chest circumference. In the EGWG group UCG concentrations correlated negatively with neonatal birth weight and birth body length. UCL correlated positively with birth body length in EGWG group and negatively with head circumference in the control group. In conclusion, EGWG is associated with disturbances in UCL and UCG concentrations.

scholarly journals Phase Angle and Bio-Impedance Values during the First Year after Delivery in Women with Previous Excessive Gestational Weight Gain: Innovative Data from the Belgian INTER-ACT Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7482
Author(s):  
Margriet Bijlholt ◽  
Kate Maslin ◽  
Lieveke Ameye ◽  
Jill Shawe ◽  
Annick Bogaerts ◽  
...  
Keyword(s):  
Body Composition ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Phase Angle ◽  
Mixed Model ◽  
Control Group ◽  
First Year ◽  
Fat Percentage ◽  
Singleton Pregnancy ◽  
Gestational Weight

Phase angle (PhA) is a body composition parameter that measures changes in the amount and quality of soft tissue. Few studies have explored PhA in pregnancy or postpartum. The aim of this study was to explore the PhA during the first year postpartum in a Belgian cohort using data from the control group of the INTER-ACT study, an intervention trial targeting those with excess gestational weight gain. A secondary aim was to examine associations between PhA and potential explanatory variables. Women aged ≥18 with excessive weight gain in a singleton pregnancy and without a chronic disease were eligible. Data collection included anthropometry as well as demographic and lifestyle questionnaires at 6 weeks, 6 months and 12 months postpartum. Body composition, including PhA, was measured with the Tanita MC780SMA device. Data was analysed using correlation and mixed model analyses. A total of 509 participants (median age 31.2) were included. The median PhA at 6 weeks postpartum was 5.8°. Higher PhA values were seen in multiparous women (p = 0.02) but there was no association with any other lifestyle or demographic factors. PhA values were positively associated with muscle mass and BMI (r = 0.13, p = 0.004 and r = 0.18, p <0.001) at 6 weeks postpartum. PhA increased slightly in the 12 months postpartum, which was related to a decrease in fat percentage (p = 0.004). Further research in the pregnant/postpartum population is needed to elucidate any links with perinatal or future health outcomes.

scholarly journals Resting energy expenditure guided intervention for gestational weight gain in obese and overweight women

2019 ◽  
Author(s):  
Xiuling Zhao ◽  
Wei Ma ◽  
Caixia Zhang ◽  
Pili Xu ◽  
Chunmei Zhang ◽  
...  
Keyword(s):  
Weight Gain ◽  
Energy Expenditure ◽  
Gestational Weight Gain ◽  
Intervention Group ◽  
Resting Energy Expenditure ◽  
Control Group ◽  
Overweight Women ◽  
Gestational Weight ◽  
Beijing China ◽  
Resting Energy

Abstract Background There is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women.Methods We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Women whose pre-pregnant body mass index was < 25Kg/m2 or who took steroid medication or those diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Participants who were recruited between May 1, 2017 and December 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Those who were recruited between November 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two study groups were then compared.Results A total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of macrosomia in the intervention group (3.12%) was also lower than in the control group (19.05%). There was no fetal growth restriction observed in either group.

Web-Based Behavioral Intervention Increases Maternal Exercise but Does Not Prevent Excessive Gestational Weight Gain in Previously Sedentary Women

2016 ◽  
Vol 13 (6) ◽  
pp. 587-593 ◽  
Author(s):  
Katie Smith ◽  
L. Lanningham-Foster ◽  
Amy Welch ◽  
Christina Campbell
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Behavioral Intervention ◽  
Late Pregnancy ◽  
Dietary Counseling ◽  
Web Based ◽  
Gestational Weight ◽  
Innovative Methods ◽  
Excessive Gestational Weight Gain ◽  
Maternal Exercise

Background:Innovative methods are warranted to optimize prenatal outcomes. This study’s objective was to determine if a web-based behavioral intervention (BI) can prevent excessive gestational weight gain (GWG) by increasing physical activity (PA).Methods:Participants were randomized to usual care (UC; n = 21) or BI (n = 24) between 10 to 14 weeks gestation. GWG, PA, and diet were assessed at baseline, mid-, and late pregnancy.Results:No differences in GWG or adherence to GWG recommendations presented between groups. Total UC MET-minutes significantly decreased from baseline to late-pregnancy (1,234 ± 372 MET-minutes, P = .013). Mid-pregnancy sustained PA was greater for BI than UC (20-minute PA bouts: 122 ± 106 vs. 46 ± 48 minutes/week, P = .005; 30-minute PA bouts: 74 ± 70 vs. 14 ± 24 minutes/week, P < .001), and greater for BI at mid-pregnancy compared with baseline (20-minute PA bouts: 61.3 ± 21.9; 30-minute PA bouts: 39.6 ± 14.8, both P < .05). BI energy intake at mid-pregnancy significantly increased from baseline (336 ± 127 kcals, P = .04) and was significantly greater than UC (2,503 ± 703 vs. 1,894 ± 594, P = .005).Conclusions:Sedentary pregnant women should increase PA but may need additional dietary counseling to prevent excessive GWG.

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