Interventions to prevent maternal obesity before conception, during pregnancy, and post partum

Abstract

Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception. To improve preconception health, an integrated approach, including pregnancy prevention, planning, and preparation is needed, involving more than the primary health-care sector and adopting an ecological approach to risk reduction that addresses personal, societal, and cultural influences. Raising awareness of the importance of good health in the period before pregnancy will require a new social movement: combining bottom-up mobilisation of individuals and communities with a top-down approach from policy initiatives. Interventions to reduce or prevent obesity before conception and during pregnancy could contribute substantially to achievement of the global Sustainable Development Goals, in terms of health, wellbeing, productivity, and equity in current and future generations.

Adolescence and the next generation

“…Similarly, adolescent and young adult alcohol use and other substance use continue to rise in many countries. Even more marked is the rise in obesity, particularly given that available antenatal interventions to reduce the metabolic consequences for both mothers and offspring are limited 128 .…”

‘Because the baby asks for it’: a mixed-methods study on local perceptions toward nutrition during pregnancy among marginalised migrant women along the Myanmar–Thailand border

“…Continued research on pregnant women nutrition along the border could produce easy-to-understand, culturally and contextually specific information materials to counsel women presenting to ANC about healthy GWG [26,27,58]. However, recent analyses suggest that such lifestyle measures are of modest benefit during pregnancy [34,59,60] and change will likely require policy interventions to improve access to healthy foods along the border to influence pre-conception maternal nutrition [61]. Similar upstream interventions should focus on accessing and educating women prior to conception, as pre-conception care is exceedingly rare in these communities [55].…”

Causes and consequences of gestational diabetes in South Asians living in Canada: results from a prospective cohort study

“…39 To our knowledge, such messaging is not routinely provided by primary care physicians or public health specialists and requires an integrated approach involving primary health care and policy initiatives. 40 The low-quality diet in the South Asian Birth Cohort (START) study was characterized by higher consumption of meat, rice and fried foods, and was lower in raw or cooked vegetables, whereas a high-quality diet included higher consumption of vegetables, legumes and whole-grain breads. 25 Given that the population attributable risk for gestational diabetes due to low diet quality in our study was 12.8%, a modified diet in which fried foods and meat were replaced with more vegetable protein and raw and cooked vegetables, and refined grains were replaced with whole grains might reduce gestational diabetes in this population by up to 13%.…”