Safety and Efficacy of a Lifestyle Intervention for Pregnant Women to Prevent Excessive Maternal Weight Gain: a Cluster-randomized Controlled Trial

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2013 Jul 20

PMID 23865624

Citations 35

Authors

Kathrin Rauh

Elisabeth Gabriel

Eva Kerschbaum

Tibor Schuster

Ruediger Von Kries

Ulrike Amann-Gassner

Hans Hauner

Affiliations

Soon will be listed here.

Abstract

Background: Excessive gestational weight gain (GWG) is associated with short- and long-term health problems among mothers and their offspring. There is a strong need for effective intervention strategies targeting excessive GWG to prevent adverse outcomes.

Methods: We performed a cluster-randomized controlled intervention trial in eight gynecological practices evaluating the feasibility and effectiveness of a lifestyle intervention presented to all pregnant women; 250 healthy, pregnant women were recruited for the study. The intervention program consisted of two individually delivered counseling sessions focusing on diet, physical activity, and weight monitoring. The primary outcome was the proportion of pregnant women exceeding weight gain recommendations of the Institute of Medicine (IOM). Secondary outcome variables were maternal weight retention and short-term obstetric and neonatal outcomes.

Results: The intervention resulted in a lower proportion of women exceeding IOM guidelines among women in the intervention group (38%) compared with the control group (60%) (odds ratio (OR): 0.5; 95% confidence interval (CI): 0.3 to 0.9) without prompting an increase in the proportion of pregnancies with suboptimal weight gain (19% vs. 21%). Participants in the intervention group gained significantly less weight than those in the control group. Only 17% of the women in the intervention group showed substantial weight retention of more than 5 kg compared with 31% of those in the control group at month four postpartum (pp) (OR: 0.5; 95% CI: 0.2 to 0.9). There were no significant differences in obstetric and neonatal outcomes.

Conclusions: Lifestyle counseling given to pregnant women reduced the proportion of pregnancies with excessive GWG without increasing suboptimal weight gain, and may exert favorable effects on pp weight retention.

Trial Registration: German Clinical Trials Register DRKS00003801.

Citing Articles

Child somatic growth and neurodevelopment: effects of pregnancy lifestyle intervention.

Geyer K, Raab R, Spies M, Knoke J, Meyer D, Brandt-Heunemann S Pediatr Res. 2025; .

PMID: 39979584 DOI: 10.1038/s41390-025-03936-y.

Rethinking causal assumptions about maternal BMI, gestational weight gain, and adverse pregnancy outcomes.

Dodd J, Louise J, Deussen A, Mitchell M, Poston L BMC Med. 2024; 22(1):197.

PMID: 38750522 PMC: 11094971. DOI: 10.1186/s12916-024-03410-2.

Effects of nutritional interventions during pregnancy on birth, child health and development outcomes: A systematic review of evidence from low- and middle-income countries.

Lassi Z, Padhani Z, Rabbani A, Rind F, Salam R, Bhutta Z Campbell Syst Rev. 2023; 17(2):e1150.

PMID: 37131924 PMC: 8356342. DOI: 10.1002/cl2.1150.

Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain.

Geyer K, Raab R, Hoffmann J, Hauner H BMC Pregnancy Childbirth. 2023; 23(1):249.

PMID: 37055730 PMC: 10100402. DOI: 10.1186/s12884-023-05569-7.

The effect of motivational interviewing and/or cognitive behaviour therapy techniques on gestational weight gain - a systematic review and meta-analysis.

Nightingale H, Mnatzaganian G, Hooker L, Barrett S, Kingsley M BMC Public Health. 2023; 23(1):626.

PMID: 37005572 PMC: 10067184. DOI: 10.1186/s12889-023-15446-9.

References

Mamun A, OCallaghan M, Callaway L, Williams G, Najman J, Lawlor D . Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: evidence from a birth cohort study. Circulation. 2009; 119(13):1720-7. DOI: 10.1161/CIRCULATIONAHA.108.813436. View

Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Duda W, Borowiack E . Interventions to reduce or prevent obesity in pregnant women: a systematic review. Health Technol Assess. 2012; 16(31):iii-iv, 1-191. PMC: 4781281. DOI: 10.3310/hta16310. View

Dodd J, Grivell R, Crowther C, Robinson J . Antenatal interventions for overweight or obese pregnant women: a systematic review of randomised trials. BJOG. 2010; 117(11):1316-26. DOI: 10.1111/j.1471-0528.2010.02540.x. View

Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P . Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med. 2012; 10:47. PMC: 3355057. DOI: 10.1186/1741-7015-10-47. View

Goldberg G, Black A, Jebb S, Cole T, Murgatroyd P, Coward W . Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr. 1991; 45(12):569-81. View

Hronek M, Zadak Z, Hrnciarikova D, Hyspler R, Ticha A . New equation for the prediction of resting energy expenditure during pregnancy. Nutrition. 2009; 25(9):947-53. DOI: 10.1016/j.nut.2009.02.011. View

Davies G, Maxwell C, McLeod L, Gagnon R, Basso M, Bos H . SOGC Clinical Practice Guidelines: Obesity in pregnancy. No. 239, February 2010. Int J Gynaecol Obstet. 2010; 110(2):167-73. DOI: 10.1016/j.ijgo.2010.03.008. View

Skouteris H, Hartley-Clark L, McCabe M, Milgrom J, Kent B, Herring S . Preventing excessive gestational weight gain: a systematic review of interventions. Obes Rev. 2010; 11(11):757-68. DOI: 10.1111/j.1467-789X.2010.00806.x. View

Huang T, Yeh C, Tsai Y . A diet and physical activity intervention for preventing weight retention among Taiwanese childbearing women: a randomised controlled trial. Midwifery. 2009; 27(2):257-64. DOI: 10.1016/j.midw.2009.06.009. View

10.

Asbee S, Jenkins T, Butler J, White J, Elliot M, Rutledge A . Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009; 113(2 Pt 1):305-12. DOI: 10.1097/AOG.0b013e318195baef. View

11.

Poudevigne M, OConnor P . A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Med. 2006; 36(1):19-38. DOI: 10.2165/00007256-200636010-00003. View

12.

Olson C, Strawderman M, Reed R . Efficacy of an intervention to prevent excessive gestational weight gain. Am J Obstet Gynecol. 2004; 191(2):530-6. DOI: 10.1016/j.ajog.2004.01.027. View

13.

Campbell F, Johnson M, Messina J, Guillaume L, Goyder E . Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data. BMC Public Health. 2011; 11:491. PMC: 3154865. DOI: 10.1186/1471-2458-11-491. View

14.

Ruchat S, Davenport M, Giroux I, Hillier M, Batada A, Sopper M . Nutrition and exercise reduce excessive weight gain in normal-weight pregnant women. Med Sci Sports Exerc. 2012; 44(8):1419-26. DOI: 10.1249/MSS.0b013e31825365f1. View

15.

Ronnberg A, Nilsson K . Interventions during pregnancy to reduce excessive gestational weight gain: a systematic review assessing current clinical evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. BJOG. 2010; 117(11):1327-34. DOI: 10.1111/j.1471-0528.2010.02619.x. View

16.

Margerison Zilko C, Rehkopf D, Abrams B . Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010; 202(6):574.e1-8. DOI: 10.1016/j.ajog.2009.12.007. View

17.

Nehring I, Schmoll S, Beyerlein A, Hauner H, von Kries R . Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr. 2011; 94(5):1225-31. DOI: 10.3945/ajcn.111.015289. View

18.

Guelinckx I, Devlieger R, Mullie P, Vansant G . Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutr. 2009; 91(2):373-80. DOI: 10.3945/ajcn.2009.28166. View

19.

Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboom T, Tomlinson J . Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012; 344:e2088. PMC: 3355191. DOI: 10.1136/bmj.e2088. View

20.

von Kries R, Nehring I . Reproductive endocrinology: reducing gestational weight gain--a panacea?. Nat Rev Endocrinol. 2012; 8(8):452-4. DOI: 10.1038/nrendo.2012.109. View