Lifestyle Modification Program Decreases Pregnancy Weight Gain in Obese Women

Abstract

We assessed the impact of a lifestyle modification program (LMP) on weight gain in pregnancy and evaluated its effect on adverse pregnancy outcomes. A prospective matched controlled study design was employed. Inclusion criteria consisted of pregnant women with singleton gestations and body mass index (BMI) > or = 30 without underlying medical conditions. In the study group, patients were prospectively enrolled in the first trimester. Through the LMP, women participated in a comprehensive program on nutrition, exercise, and weight control in pregnancy. The control group consisted of matched patients by starting BMI, parity, and socioeconomic status during the same study period cared for at the same institution. The primary outcome evaluated was weight gain in pregnancy. Adverse pregnancy outcomes including preeclampsia, gestational diabetes, gestational hypertension, and various postpartum complications were evaluated between the two groups. Statistical analysis was performed using nonparametric methods, with p < 0.5 considered significant. Twenty-eight patients were recruited for this study and underwent the intervention. Patient compliance with the LMP was 75%, two patients were lost to follow-up, one had a preterm delivery, and four had incomplete data due to various reasons. Twenty-one patients completed their pregnancy and were available for analysis. Twenty matched control patients were identified for analysis. Study participants gained significantly less weight in their pregnancies when compared with controls (mean weight gain 17 versus 34 pounds, respectively; p = 0.008). Secondary outcomes of preeclampsia, gestational diabetes, cesarean section, as well as infant birth weight did not significantly differ between the groups. This study suggests an effective method of reducing prenatal weight gain in the obese population. This type of comprehensive intervention could be an important, cost-effective risk-reduction strategy.

Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioner's perspectives

“…Potter et al [45] surveyed 366 adult patients from 2 primary care practices and found that one of the components the patients reported most wanting to help them achieve successful weight loss was physician help in setting realistic weight goals. Whilst intervention studies incorporating provision of recommendations for weight gain in pregnancy as part of their intervention component are scarce [45][46][47][48][49][50] and have produced mixed results, setting realistic weight gain targets in shared antenatal care for women could be a promising step in providing support aimed at preventing excess GWG.…”

Feasibility and Potential Benefits of a Self-Monitoring Enhanced Lifestyle Intervention to Prevent Excessive Gestational Weight Gain in Women Who Are Overweight or Obese

“…A previous study with 21 obese pregnant women and using food diaries and pedometers to enhance lifestyle change demonstrated positive outcomes in preventing EGWG (Schirazian, Monteith, Friedman, & Rebarber, 2010). Our plan was to enroll 20-25 women to assess feasibility.…”

Exercise Guidelines for Women with Gestational Diabetes

“…Interventions that combined exercise and dietary counseling were found to be more successful in limiting GWG, with an average reduction of GWG of 1.2 kg (p=0.01) found in the intervention groups compared to the control groups (Streuling et al, 2010b). Three studies found significant lower GWG in the exercise plus nutrition intervention group compared with the control groups (Asbee et al, 2009;Claesson et al, 2008;Shirazian et al, 2010), 3 studies found a non significant trend in lower GWG in the intervention group compared with the control group (Gray-Donald et al, 2000;Guelinckx et al, 2010;Olson et al, 2004) and three found no significant results (Hui et www.intechopen.com al., 2006;Kinnunen et al, 2007;Polley et al, 2002). Findings from intervention studies using only exercise were less consistent than findings from intervention studies combining exercise and nutrition.…”