Intervention strategies for preventing excessive gestational weight gain: systematic review and meta‐analysis

Shieh, Carol; Cullen, Deborah; Pike, Caitlin; Pressler, Susan J.

doi:10.1111/obr.12691

Cited by 62 publications

(68 citation statements)

References 45 publications

(460 reference statements)

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“…It is evident that the risk of pre-eclampsia increases with the degree of weight gain; therefore preventative strategies should be focussed on getting women, especially those already overweight, to reduce weight prior to conception. Weight loss in pregnancy requires careful management in order to avoid unintended consequences 19. Nevertheless, women often engage with health professionals during pregnancy; therefore dietary and lifestyle interventions such as physical activity, which have been shown by reviews and meta-analyses19 20 to reduce gestational weight gain and improve outcomes for both mother and baby, could be provided to them.…”

Section: Discussionmentioning

confidence: 99%

Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

et al. 2020

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ObjectiveTo examine the association between high maternal weight status and complications during pregnancy and delivery.SettingScotland.ParticipantsData from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated.Outcome measuresGestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age.ResultsIn the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29).ConclusionsWomen with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

et al. 2020

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“…Una revisión sistemática reportó que cuantificar el peso como intervención aislada en la atención prenatal no es eficaz en reducir el aumento de peso durante la gestación (40) , por lo que se recomienda como parte de las intervenciones que el profesional de la salud trabaje en colaboración con las madres para lograr los objetivos de aumento de peso; monitorizar y brindar retroalimentación sobre su progreso (40) , tener enfoques estandarizados y basados en evidencia científica (41) , mejorar el conocimiento y las creencias sobre la ganancia de peso en mujeres en edad fértil (42) , incorporar un enfoque holístico integrando no solo a la gestante, sino a la familia o su entorno social (43) , proporcionar consulta nutricional sobre una alimentación saludable; con el objetivo orientado en las calorías, macronutrientes necesitados y niveles adecuados de actividad física (44) , acompañar las actividades dietéticas con estrategias de cambios de comportamiento, principalmente en la provisión de información, entrevistas motivacionales, automonitoreo y recompensas contingentes (45) , logrando brindar un cuidado prenatal con enfoque multidisciplinario (46,47) . No se ha determinado con exactitud la duración, frecuencia, intensidad o el entorno óptimo para brindar estas intervenciones (48) .…”

Section: Discussionunclassified

Ganancia de peso gestacional como predictor de macrosomía y bajo peso al nacer: revisión sistemática

Santos-Antonio

Alvis-Chirinos

Aguilar-Esenarro

et al. 2020

Rev Peru Med Exp Salud Publica

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Objetivos: Evaluar la capacidad predictiva de las recomendaciones de ganancia de peso gestacional respecto del bajo peso al nacer (BPN) y la macrosomía neonatal, propuestas por el Institute of Medicine (IOM) y el Centro Latinoamericano de Perinatología (CLAP). Materiales y métodos: La búsqueda bibliográfica se realizó en PubMed, Embase (vía Ovid), Cochrane Library, EBSCOhost, Scopus, LILACS y SciELO. La calidad metodológica se evaluó utilizando QUADAS 2. Resultados: Se obtuvieron 1192 artículos, cinco cumplieron los criterios de inclusión, ningún estudio evaluó las recomendaciones CLAP. La sensibilidad y especificidad para predecir el BPN y la macrosomía variaron largamente según el país de realización del estudio. En las cohortes de América Latina, la sensibilidad para predecir el BPN varió entre 62,8% y 74%, y la especificidad, entre 61,7% y 68%, mientras que la sensibilidad para predecir macrosomía fue 28,8%, y la especificidad, 43,8%. En la mayoría de estudios el valor predictivo positivo fue inferior al 25%, y el valor predictivo negativo, superior al 90%. La mayoría de los estudios tuvo alto riesgo de sesgo y problemas de aplicabilidad en la selección de pacientes. Conclusiones: La limitada calidad metodológica y representatividad de las cohortes estudiadas, probables factores de confusión no ajustados y modestos valores de sensibilidad y especificidad sugieren la necesidad de desarrollar estudios para establecer recomendaciones que se ajusten a las características epidemiológicas de la población peruana.

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“…They concluded that healthy eating with calorie and macronutrient goals are especially effective in limiting excessive GWG among pregnant overweight and obese women. The outcome of the neonates was not studied [20].…”

Section: Lifestyle Interventions To Prevent Gdmmentioning

confidence: 99%

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

2020

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Gestational diabetes (GDM) has deleterious effects on the offspring. Maternal obesity and excessive gestational weight gain (GWG), often associated with diabetes, also contribute to these adverse outcomes. Objectives: To assess the benefit for the offspring of maternal lifestyle interventions, including diets and physical activity, to prevent or to improve GDM and to limit excessive GWG. Method: Systematic review of meta-analyses published in English between December 2014 and November 2019. Results: Lifestyle interventions to reduce the risk of GDM reported a decreased risk of 15% to 40%, with a greater effect of exercise compared to diet. Combined lifestyle interventions specifically designed to limit GWG reduced GWG by 1.6 kg in overweight and obese women, and on average by 0.7 to 1 kg in all pregnant women. In these trials, adverse neonatal outcomes were poorly studied. Combined lifestyle interventions in women with GDM significantly reduced fetal growth. Altogether, lifestyle interventions reduced the risk of preterm birth and shoulder dystocia, but individually, diets or exercise alone had no effect on neonatal adverse outcomes. Conclusion: Specific maternal, neonatal and offspring benefits of lifestyle interventions during pregnancy to prevent or improve GDM control or to limit GWG still require clarification.

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Intervention strategies for preventing excessive gestational weight gain: systematic review and meta‐analysis

Abstract: Healthy eating and/or physical activity are effective in gestational weight gain control. Healthy eating with calorie and macronutrient goals are especially effective in limiting excessive gestational weight gain among pregnant overweight and obese women.

Cited by 62 publications

References 45 publications

Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

Ganancia de peso gestacional como predictor de macrosomía y bajo peso al nacer: revisión sistemática

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

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