Routine weighing to reduce excessive antenatal weight gain: a randomised controlled trial

Brownfoot, Fiona; Davey, Mary‐Ann; Kornman, Louise

doi:10.1111/1471-0528.13735

Cited by 34 publications

(70 citation statements)

References 28 publications

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“…67686970717273747576777879808182838485868788 A further 45 trials (9945 women)8990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133 were identified after the IPD acquisition timeline until February 2017.…”

Section: Resultsmentioning

confidence: 99%

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

2017

BMJ

259

184

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ObjectiveTo synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women's body mass index, age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications. DESIGNSystematic review and meta-analysis of individual participant data (IPD). DATA SOURCESMajor electronic databases from inception to February 2017 without language restrictions. ELIGIBILITY CRITERIA FOR SELECTING STUDIESRandomised trials on diet and physical activity based interventions in pregnancy. DATA SYNTHESISStatistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall, and in subgroups (interactions). RESULTS IPD CONCLUSIONDiet and physical activity based interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. There is no evidence that effects differ across subgroups of women.

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Section: Resultsmentioning

confidence: 99%

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

2017

BMJ

259

184

View full text Add to dashboard Cite

show abstract

“…Both groups received standard antenatal care [37]. The second study by Brownfoot et al [38] trialled the intervention of clinician weighing of pregnant women during scheduled antenatal care visits. The control group were weighed at the time of recruitment into the study (<21 weeks gestation) and again at 36 weeks gestation only [38].…”

Section: Resultsmentioning

confidence: 99%

“…The second study by Brownfoot et al [38] trialled the intervention of clinician weighing of pregnant women during scheduled antenatal care visits. The control group were weighed at the time of recruitment into the study (<21 weeks gestation) and again at 36 weeks gestation only [38]. Both groups received standard antenatal care following the participating hospitals guidelines.…”

Section: Resultsmentioning

confidence: 99%

Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials

Fealy

Taylor

Foureur

et al. 2017

BMC Pregnancy Childbirth

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BackgroundExcessive gestational weight gain is associated with short and long-term adverse maternal and infant health outcomes, independent of pre-pregnancy body mass index. Weighing pregnant women as a stand-alone intervention during antenatal visits is suggested to reduce pregnancy weight gain. In the absence of effective interventions to reduce excessive gestational gain within the real world setting, this study aims to test if routine weighing as a stand-alone intervention can reduce total pregnancy weight gain and, in particular, excessive gestational weight gain.MethodsA systematic review and meta–analysis of randomised controlled trials (RCTs) was conducted between November 2014 and January 2016, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seven databases were searched. A priori eligibility criteria were applied to published literature by at least two independent reviewers. Studies considered methodologically rigorous, as per the Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research, were included. Meta-analysis was conducted using fixed-effects models.ResultsA total of 5223 (non-duplicated) records were screened, resulting in two RCTs that were pooled for meta-analysis (n = 1068 randomised participants; n = 538 intervention, n = 534 control). No difference in total weight gain per week was observed between intervention and control groups (weighted mean difference (WMD) -0.00 kg/week, 95% confidence interval (CI) -0.03 to 0.02). There was also no reduction in excessive gestational weight gain between intervention and control, according to pre-pregnancy body mass index (BMI). However, total weight gain was lower in underweight women (n = 23, BMI <18.5 kg/m2) in the intervention compared to control group (−0.12 kg/week, 95% CI −0.23 to −0.01). No significant differences were observed for other pregnancy, birth and infant outcomes.ConclusionWeighing as a stand-alone intervention is not worse nor better at reducing excessive gestational weight gain than routine antenatal care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1207-2) contains supplementary material, which is available to authorized users.

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“…Earlier guidelines from 1990 used different BMI cut-offs, categorizing more women as underweight or obese and fewer as normal-weight or overweight [8], and advised women with obesity to gain at least 6 kg with no upper limit mentioned [9]. Regardless of pre-pregnancy BMI more than 70% of women exceed the current recommendations [10, 11]. Even with intervention programs aimed to limit weight gain during pregnancy, about 40–60% of women still gain excessively [10, 12–14].…”

Section: Introductionmentioning

confidence: 99%

“…Regardless of pre-pregnancy BMI more than 70% of women exceed the current recommendations [10, 11]. Even with intervention programs aimed to limit weight gain during pregnancy, about 40–60% of women still gain excessively [10, 12–14]. The limited success of weight management during pregnancy and the scarce existence of weight loss support postpartum is unfortunate since recent studies show that weight-retention of two BMI units or more increases the risks in subsequent pregnancies for gestational diabetes, hypertension, stillborn babies and early infant death [15, 16].…”

Section: Introductionmentioning

confidence: 99%

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

et al. 2016

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IntroductionObesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.MethodsQualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.ResultsParticipants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.ConclusionThere is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

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Routine weighing to reduce excessive antenatal weight gain: a randomised controlled trial

Cited by 34 publications

References 28 publications

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

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