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Lifestyle interventions may not be enough to prevent pregnancy complications in overweight women

Pregnant women who were overweight and took part in an intervention designed to limit weight gain better managed their weight, but the outcome of their pregnancy did not improve, according to findings presented at The Pregnancy Meeting.

“While pregnant women should still be counseled against excess weight gain, additional measures may be required to reduce the associated complications,” Alan Peaceman, MD, department of obstetrics and gynecology at Northwestern University, Chicago, said in a press release.

Peaceman and colleagues randomly placed 281 patients with BMIs between 25 kg/m² and 40 kg/m² who were less than 16 weeks pregnant into usual care or the lifestyle intervention. Women in both groups had similar race, gender, pre-pregnancy BMI, gestational age at randomization, parity and maternal age.

According to the researchers, women who had bariatric surgery, in vitro fertilization, multiple pregnancies or pre-gestational diabetes were not included were not in the study.

The usual care participants were provided non-diet related pregnancy information, electronic newsletters and websites. The lifestyle intervention participants received personalized dietitian-prescribed calorie-specific dietary approach to stop hypertension (DASH)-type diets, physical activity, internet-based self-monitoring of diet adherence, and weekly coaching calls, with opportunities for podcasts, webinars and group visits.

The researchers stated that there were four pregnancy losses after randomization but before 24 weeks, and one fetal death after 6 months. The intervention group had a higher rate of cesarean births and gained significantly less weight from enrollment to 36 weeks than the usual care group. In addition, fewer participants exceeded the Institute of Medicine recommendations for gestational weight gain but this did not lead to fewer diagnoses of preeclampsia, gestational diabetes or hypertension, or birth weight of more than 4 kg. – by Janel Miller

Reference:  Peaceman, AM, et al. MOMFIT: A randomized clinical trial of an intervention to prevent excess gestational weight gain in overweight and obese women. Presented at: The Pregnancy Meeting; Jan. 23-28, 2017; Las Vegas.

Disclosure: Healio Family Medicine was unable to determine researchers’ relevant financial disclosures prior to publication.