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

Abstract

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 Örebro county, Sweden, participated.

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

Keywords: Gestational weight gain; maternal health; pregnancy; prevention of obesity.