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Intervention during pregnancy to reduce excessive gestational weight gain: a randomised controlled trial
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden .
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. 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 .
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2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 4, p. 537-544Article in journal (Refereed) 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

Place, publisher, year, edition, pages
2015. Vol. 122, no 4, p. 537-544
Keywords [en]
Gestational weight gain, maternal health, pregnancy, prevention of obesity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
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
Note

Funding Agency:

Research Committee at Orebro County Council

Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2018-06-27Bibliographically approved
In thesis
1. Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention
Open this publication in new window or tab >>Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. p. 61
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 146
Keywords
gestational weight gain, maternal health, pregnancy, prevention of obesity, lifestyle intervention, childhood obesity
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-51439 (URN)978-91-7529-148-2 (ISBN)
Public defence
2016-09-30, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
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Available from: 2016-07-25 Created: 2016-07-25 Last updated: 2017-10-17Bibliographically approved

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Rönnberg, AnnKristinÖstlund, IngridFadl, HelenaNilsson, Kerstin

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Rönnberg, AnnKristinÖstlund, IngridFadl, HelenaNilsson, Kerstin
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School of Health and Medical Sciences, Örebro University, SwedenÖrebro University HospitalSchool of Medicine, Örebro University, Sweden
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British Journal of Obstetrics and Gynecology
Obstetrics, Gynecology and Reproductive Medicine

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