A randomized controlled trial of daily weighing in pregnancy to control gestational weight gain

Abstract

Background: Excessive gestational weight gain is a modifiable risk factor for the development of obstetric and neonatal complications, and can have a lifelong impact on the health of both mother and offspring. The purpose of this study was to assess whether in addition to standardized medical advice regarding weight gain in pregnancy (including adherence to the Institute of Medicine (IOM) guidelines) (IOM (Institute of Medicine) and NRC (National Research Council, Weight Gain During Pregnancy: Reexamining the guidelines, 2009)), the addition of daily weighing would provide a low cost and simple intervention to reduce excessive weight gain in pregnancy by maintaining weight gain within the target range. Methods: Women presenting for antenatal care to a secondary level hospital were randomised to routine care or daily weight monitoring. Both groups received nutrition and exercise advice. Results: Three hundred and ninety-six women were randomised to either the daily weight monitoring group or control group with complete data available for 326 women. The percentage weight gain above target (86.9% (SD 52.3) v 92.7% (SD 50.8) p = 0.31) and change in weight per week during the study period (0.59 kg (SD 0.30) v 0.63 kg (SD 0.31) p = 0.22) were lesser in those undergoing daily weighing compared to routine management, however these did not reach statistical significance. Conclusion: Daily weight monitoring as a stand-alone intervention has potential to reduce excessive gestational weight gain. It may have a role as a part of a larger intervention involving dietary and exercise modifications. Trial registration: The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry. (ACTRN12613001165774, 23/10/ 2013).

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

“…Excessive GWG is common and associated with increased adverse maternal and neonatal pregnancy outcomes. In this study, we found level 1 evidence from 117 RCTs, which involved 34 546 women, more than 30 years of research, and 5 continents . Compared with routine care, antenatal diet and physical activity–based lifestyle interventions were associated with reduced GWG.…”

“…The search identified 7500 studies, of which 178 were retained for full-text review and 28 were included in the present analysis . In the 2017 systematic review, 103 studies were identified, of which 89 were eligible .…”

“…In the 2017 systematic review, 103 studies were identified, of which 89 were eligible . The 28 new and 89 previous articles were combined for a total of 117 studies for the present meta-analysis . The PRISMA diagram is presented in Figure 1.…”

Key Components of Antenatal Lifestyle Interventions to Optimize Gestational Weight Gain

“…Of 117 studies included in our systematic review, 99 studies reported GWG data and were included in this TIDieR meta-analysis (eFigure in Supplement 1), with general characteristics of studies previously reported . Of 34 546 pregnant individuals recruited, the mean (SD) baseline BMI ranged from 20.6 (2.5) to 38.6 (6.1) .…”

Implementation of Antenatal Lifestyle Interventions Into Routine Care

“…Study characteristics are presented in Table 2. Intervention types were structured diet in 13 studies, structured physical activity in 42 studies, diet with physical activity with at least 1 element structured in 16 studies, and mixed interventions that did not meet these criteria in 28 studies . Forty-one studies were conducted in Europe, 34 in the Americas, 13 in Oceania, and 11 in Asia.…”