This article is more than 5 years old. Information may no longer be current.
Prenatal care-based interventions limit gestational weight gain in women with overweight, obesity
Pregnant women with overweight or obesity who participated in weight-loss interventions delivered by prenatal care physicians saw a greater reduction in gestational weight gain compared with women participating in interventions in alternate settings or with nonprenatal care providers, according to a meta-analysis of randomized controlled trials.
“When it comes to weight management for obese and overweight women during pregnancy, receiving lifestyle counseling coming from their prenatal care providers is the most effective intervention,” SeonAe Yeo, RNC, PhD, FAAN, of the School of Nursing at the University of North Carolina at Chapel Hill, told Endocrine Today. “Group programs in nonclinical settings are not effective for pregnant women.”
Yeo and colleagues analyzed data from 32 randomized controlled trials involving pregnant women with overweight or obesity who participated in weight-loss interventions between 2005 and June 2016 (n = 5,869). Researchers used random-effects models to calculate the mean difference in gestational weight gain between intervention and control groups across studies.
Researchers found that nine of the 32 studies reported gestational weight gain reductions in response to intervention; six of the nine studies were delivered by primary care physicians, with most interventions targeting physical activity and/or diet (26 studies). Across studies, women in the intervention groups gained 1.71 kg less on average than women in the control groups (95% CI, –2.55 to –0.86).
Women had a greater reduction in gestational weight gain when participating in interventions delivered by a prenatal care physician (weighted mean difference, –3.88 kg; 95% CI, –7.01 to –0.75) vs. when participating in an intervention delivered by a nonprenatal care provider (weighted mean difference, –0.8 kg; 95% CI, –1.32 to –0.28).
The researchers noted that there was high heterogeneity across the studies, suggesting inconsistencies in calculating gestational weight gain and varying effectiveness among different study populations, intervention strategies and delivery settings.
“Additional support from dietitians, health educators and exercise trainers is important to counsel efficiently during busy clinic visits, but the prenatal care providers need to remain the main messenger,” Yeo said. “Prenatal care providers need to address lifestyle management with all overweight and obese pregnant women because that will result in significantly less weight gain, which in turn helps them avoid postpartum weight retention.
“Because prenatal care provision is uneven by region and health system, the implementation of lifestyle intervention programs needs to be tested and evaluated and systematized,” Yeo said. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.