Resting Energy Expenditure Guided Intervention for Gestational Weight Gain in Obese and Overweight Women

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold>There is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women. <jats:bold>Methods </jats:bold>We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Pregnant women who took steroid medication or who were diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Women who were recruited between May 1, 2017 and November 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Women who were recruited between December 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two groups were compared.<jats:bold>Results</jats:bold>A total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain (GWG) in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of excess GWG in the intervention group (37.59%) was also lower than in the control group (66.67%). The REE in women of the intervention group with excess GWG increased faster than women with appropriate GWG during pregnancy, especially from 1<jats:sup>st</jats:sup> trimester to 2<jats:sup>nd</jats:sup> trimester. Rate of macrosomia in the intervention group (3.12%) was lower than in the control group (19.05%). There was no fetal growth restriction observed in either group. <jats:bold>Conclusion</jats:bold>: Resting energy expenditure guided nutrition intervention during pregnancy may lower GWG and lower incidence of macrosomia, with no apparent impact on fetal growth restriction. Future studies with larger sample size and randomized controlled trial design are needed to confirm findings from this small-scale study.</jats:p>