Limiting antenatal weight gain improves maternal health outcomes in severely obese pregnant women: findings of a pragmatic evaluation of a midwife-led intervention

McGiveron, Ailsa; Foster, Sally; Pearce, Joanne; Taylor, Moira A.; McMullen, Sarah; Langley-Evans, Simon C.

Abstract

Background: Antenatal obesity in pregnancy is associated with complications of pregnancy and poor obstetric outcomes. Although most guidance on pregnancy weight is focused on the pre-pregnancy period, pregnancy is widely viewed as a period where women are open to lifestyle change to optimise their health.

Method: The hospital-based Bumps and Beyond intervention invited all pregnant women with a BMI of over 35 kg/m2 to take part in a programme of health education around diet and exercise, accompanied by one-to-one guidance and monitoring of dietary change. This service evaluation compares 89 women who completed at a programme of 7 sessions with healthy lifestyle midwives and advisors (intervention) with a group of 89 women who chose not to attend (non-intervention).

Results: Weight gain in the intervention group (4.5±4.6 kg) was less than in the non-intervention group (10.3±4.4 kg) between antenatal booking and 36 weeks gestation (<0.001). This was associated with a 95% reduction in the risk of gestational hypertension during pregnancy and a general reduction in pregnancy complications. There was no effect of the intervention upon gestational diabetes or complications in labour other than post-partum haemorrhage (reduced 55%). The impact of the intervention on gestational weight gain was greater in women with BMI over 40 kg/m2 at booking. There were no adverse effects of the intervention, even though 21% of the intervention group lost weight during their pregnancy.

Conclusion: Intensive, personalised weight management intervention may be an effective strategy for prevention of hypertensive disorders during pregnancy.

Citation

McGiveron, A., Foster, S., Pearce, J., Taylor, M. A., McMullen, S., & Langley-Evans, S. C. (2014). Limiting antenatal weight gain improves maternal health outcomes in severely obese pregnant women: findings of a pragmatic evaluation of a midwife-led intervention. Journal of Human Nutrition and Dietetics, 28(S1), https://doi.org/10.1111/jhn.12240

• Journal Article Type: Article
• Acceptance Date: Feb 1, 2014
• Publication Date: May 9, 2014
• Deposit Date: Mar 16, 2015
• Publicly Available Date: Mar 16, 2015
• Journal: Journal of Human Nutrition and Dietetics
• Print ISSN: 0952-3871
• Electronic ISSN: 1365-277X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Issue: S1
• DOI: https://doi.org/10.1111/jhn.12240
• Public URL: https://nottingham-repository.worktribe.com/output/728894
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/jhn.12240/abstract
• Additional Information: This is the pre-peer reviewed version of the following article: McGiveron A., Foster S., Pearce J., Taylor M.A., McMullen S. & Langley-Evans S.C. (2015) Limiting antenatal weight gain improves maternal health outcomes in severely obese pregnant women: findings of a pragmatic evaluation of a midwife-led intervention. Journal of Human Nutrition and Dietetics. 28 (Suppl. 1), 29–37, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jhn.12240/abstract
• Contract Date: Mar 16, 2015