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Meta-Analysis
. 2012 Apr 18;4(4):CD007145.
doi: 10.1002/14651858.CD007145.pub2.

Interventions for preventing excessive weight gain during pregnancy

Benja Muktabhant  1 , Pisake Lumbiganon, Chetta Ngamjarus, Therese Dowswell
Affiliations
Meta-Analysis

Interventions for preventing excessive weight gain during pregnancy

Benja Muktabhant et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Excessive weight gain during pregnancy is associated with multiple maternal and neonatal complications. However, interventions to prevent excessive weight gain during pregnancy have not been adequately evaluated.

Objectives: To evaluate the effectiveness of interventions for preventing excessive weight gain during pregnancy and associated pregnancy complications.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 October 2011) and MEDLINE (1966 to 20 October 2011).

Selection criteria: All randomised controlled trials and quasi-randomised trials of interventions for preventing excessive weight gain during pregnancy.

Data collection and analysis: We assessed for inclusion all potential studies we identified as a result of the search strategy. At least two review authors independently assessed trial quality and extracted data. We resolved discrepancies through discussion. We have presented results using risk ratio (RR) for categorical data and mean difference for continuous data. We analysed data using a fixed-effect model.

Main results: We included 28 studies involving 3976 women; 27 of these studies with 3964 women contributed data to the analyses. Interventions focused on a broad range of interventions. However, for most outcomes we could not combine data in a meta-analysis, and where we did pool data, no more than two or three studies could be combined for a particular intervention and outcome. Overall, results from this review were mainly not statistically significant, and where there did appear to be differences between intervention and control groups, results were not consistent. For women in general clinic populations one (behavioural counselling versus standard care) of three interventions examined was associated with a reduction in the rate of excessive weight gain (RR 0.72, 95% confidence interval 0.54 to 0.95); for women in high-risk groups no intervention appeared to reduce excess weight gain. There were inconsistent results for mean weight gain (reported in all but one of the included studies). We found a statistically significant effect on mean weight gain for five interventions in the general population and for two interventions in high-risk groups.Most studies did not show statistically significant effects on maternal complications, and none reported significant effects on adverse neonatal outcomes.

Authors' conclusions: There is not enough evidence to recommend any intervention for preventing excessive weight gain during pregnancy, due to the significant methodological limitations of included studies and the small observed effect sizes. More high-quality randomised controlled trials with adequate sample sizes are required to evaluate the effectiveness of potential interventions.

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Figures

Figure 1
Figure 1. Methodological quality summary: review authors’ judgements about each methodological quality item for each included study
Figure 2
Figure 2. Methodological quality graph: review authors’ judgements about each methodological quality item presented as percentages across all included studies
See this image and copyright information in PMC

References

References to studies included in this review

    1. *

    2. Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstetrics & Gynecology. 2009;113:305–12. - PubMed
    1. Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Dietary counseling prevents excessive weight gain during pregnancy, a randomized controlled trial. Obstetrics & Gynecology. 2008;11(4 Suppl):6S. - PubMed
    1. Barakat R, Pelaez M, Montejo R, Luaces M, Zakynthinaki M. Exercise during pregnancy improves maternal health perception: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2011;204(5):402.e1–7. - PubMed
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    1. Boileau PA. Control of weight-gain during pregnancy: use of diethylpropion hydrochloride. Applied Therapeutics. 1968;10:763–5. - PubMed

References to studies excluded from this review

    1. Breslow S, Belafsky HA, Shangold JE, Hirsch LM, Stahl MB. Control of weight gain in pregnancy: double blind study of a dieting aid. Clinical Medicine. 1963;70:931–8. - PubMed
    1. Campbell MK, Carbone E, Honess-Morreale L, Heisler-Mackinnon J, Demissie S, Farrell D. Randomized trial of a tailored nutrition education CD-ROM program for women receiving food assistance. Journal of Nutrition Education & Behavior. 2004;36(2):58–66. - PubMed
    1. Faucher MA. Promotoras de salud and portion control: a community intervention aimed at weight loss in low-income Mexican-American women. Journal of Midwifery and Women’s Health. 2008;53(5):482.
    1. Gray-Donald K, Robinson E, Collier A, David K, Renaud L, Rodrigues S. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. CMAJ: Canadian Medical Association Journal. 2000;163(10):1247–51. - PMC - PubMed
    1. Hausenblas HA, Brewer BW, Van Raalte JL, Cook B, Downs DS, Weis CA, et al. Development and evaluation of a multimedia CD-ROM for exercise during pregnancy and postpartum. Patient Education and Counseling. 2008;70(2):215–9. - PMC - PubMed

References to studies awaiting assessment

    1. Leiferman J. My baby, my move: an antenatal community-based physical activity intervention. Annals of Behavioral Medicine. 2011;41(Suppl 1):S135.
    1. Mohebi S. [accessed 6 December 2010];Effect of nutrition education program on the recommended weight gain during pregnancy in pregnant women; application of health belief model. Iranian Registry of Clinical Trials. http://www.irct.ir/

References to ongoing studies

    1. Althuizen E, Van Poppel MN, Seidell JC, Van der Wijden C, Van Mechelen W. Design of the new life(style) study: a randomised controlled trial to optimise maternal weight development during pregnancy. BMC Public Health. 2006;6:168. - PMC - PubMed
    1. Brand-Miller J. [accessed 31 October 2010];A pregnancy intervention to reduce postprandial glucose excursions in the primary prevention of paediatric obesity. Current Controlled Trials. www.controlled-trials.com/
    1. Brand-Miller J. [accessed 11 February 2011];A randomized, two-arm parallel dietary intervention study to compare the effects of consuming a low glycemic diet or wholegrain high fibre diet on infant birth weight and body composition, complications related to Gestational Diabetes Mellitus (GDM) and progression to GDM diagnosis in women at high-risk of GDM. Australian New Zealand Clinical Trials Register. www.anzctr.org.au.
    1. Brownfoot F. [accessed 27 July 2011];In antenatal women, does weighing at each visit compared with routine antenatal care reduce the incidence of excessive weight gain during pregnancy? Australian New Zealand Clinical Trials Register. www.anzctr.org.au.
    1. Chasan-Taber L, Marcus BH, Stanek E, 3rd, Ciccolo JT, Marquez DX, Solomon CG, et al. A randomized controlled trial of prenatal physical activity to prevent gestational diabetes: design and methods. Journal of Women’s Health. 2009;18(6):851–9. - PMC - PubMed

Additional references

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    1. Abrams B, Carmichael S, Selvin S. Factors associated with the pattern of maternal weight gain during pregnancy. Obstetrics & Gynecology. 1995;86(2):170–6. - PubMed
    1. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. American Journal of Clinical Nutrition. 2000;71(5 Suppl):1233S–1241S. - PubMed
    1. Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstetrics & Gynecology. 1998;91(1):97–102. - PubMed
    1. Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. International Journal of Gynecology & Obstetrics. 2006;93(3):269–74. - PubMed

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