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Intervention during pregnancy to reduce excessive gestational weight gain: a randomised controlled trial
Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden .
Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.ORCID-id: 0000-0002-2691-7525
Department of Obstetrics and Gynaecology, Linköping University Hospital, Linköping, Sweden .
Vise andre og tillknytning
2015 (engelsk)Inngår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, nr 4, s. 537-544Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

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 orebro county, Sweden, participated.

Population: Healthy women with a body mass index (BMI) 19kg/m(2), age 18years and adequate knowledge of Swedish language who signed in for maternity care at 16weeks 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, 14.2kg (SD 4.4) versus 15.3kg (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

sted, utgiver, år, opplag, sider
2015. Vol. 122, nr 4, s. 537-544
Emneord [en]
Gestational weight gain, maternal health, pregnancy, prevention of obesity
HSV kategori
Forskningsprogram
Obstetrik och gynekologi
Identifikatorer
URN: urn:nbn:se:oru:diva-44110DOI: 10.1111/1471-0528.13131ISI: 000350139300022PubMedID: 25367823Scopus ID: 2-s2.0-84923328050OAI: oai:DiVA.org:oru-44110DiVA, id: diva2:801139
Merknad

Funding Agency:

Research Committee at Orebro County Council

Tilgjengelig fra: 2015-04-08 Laget: 2015-04-08 Sist oppdatert: 2018-06-27bibliografisk kontrollert
Inngår i avhandling
1. Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention
Åpne denne publikasjonen i ny fane eller vindu >>Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention
2016 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Background: Excessive gestational weight gain (GWG) is common in developed countries and is associated with an increased risk of maternal and offspring morbidity. Evidence regarding efficacy and safety of antenatal lifestyle intervention is limited in terms of both systematic reviews and original trials. This thesis is based on the need to further explore this research area. Objectives: To assess and grade current evidence and evaluate short and long-term effects of an antenatal lifestyle intervention on women and their offspring Materials: Controlled trials of intervention publishedbefore August 2009 were systematically searched and reviewed. A randomized controlled trial (RCT) including 445 healthy women aged >18 years with a body mass index (BMI) ≥19 and ≤16 weeks pregnant and their offspring was performed during 2007-2015 in Örebro Region, Sweden. Methods: The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used for review. Our RCT (called the VIGA trial) compared standard care with a composite intervention consisting of education, application of a personalized weight graph, prescription of exercise and more frequent monitoring of weight. Standardized measures of weight and height in offspring waere analysed based on World Health Organization (WHO) Child Growth Standards. Results: Quality of evidence across the studies published pre-August 2009 was concluded to be very low. Our intervention significantly reduced mean GWG (kg) but the proportion of women with excessive GWG, according to recommendations, was not significantly reduced. Short- term postpartum weight retention (PPWR) was significantly lower after the intervention but no significant difference remained 1 year after delivery. Offspring mean BMI z-scores or proportion of obesity did not differ between study groups at either birth or age 5. Conclusions: The antenatal lifestyle intervention reduced mean GWG and short-term PPWR but no long-term effects on maternal weight retention or offspring obesity were seen. Alternative modes and timing of intervention should be considered in future research. Reducing the prevalence of pre-conception obesity must still be considered the primary means to improve maternal and fetal outcome.

sted, utgiver, år, opplag, sider
Örebro: Örebro university, 2016. s. 61
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 146
Emneord
gestational weight gain, maternal health, pregnancy, prevention of obesity, lifestyle intervention, childhood obesity
HSV kategori
Forskningsprogram
Kirurgi
Identifikatorer
urn:nbn:se:oru:diva-51439 (URN)978-91-7529-148-2 (ISBN)
Disputas
2016-09-30, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2016-07-25 Laget: 2016-07-25 Sist oppdatert: 2017-10-17bibliografisk kontrollert

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