Weight Advice in Pregnancy
Weight Gain Study Background
According to the Institute of Medicine (IOM) normal-weight women (BMI
(body mass index) of 19.8-26.0) gain 25-35 lb (11.4-15.9 kg) during pregnancy
and overweight women (BMI of 26.1-29.0) gain 15-25 lbs (6.8-11.4 kg).
A significant number of normal-weight women and an even greater proportion
of overweight women exceed these guidelines, which increases postpartum
weight retention and may contribute to the development of obesity.
Weight Gain Study Aim
To determine whether a stepped care, behavioral intervention will decrease
the percentage of women who gain more weight than the IOM recommendation.
Weight Gain Study Design
Randomized controlled trial comparing a stepped-care behavioral intervention
with usual care. Women (n=120) who had a BMI>19.8, aged over 18 and
under 20 weeks gestation were recruited from a hospital-based clinic serving
low-income women and randomized by race and BMI category to the intervention
or control group. The intervention group received education about weight
gain, healthy eating, and exercise and individual graphs of their weight
gain. Those exceeding weight gain goals were given more intensive intervention.
Women were followed through pregnancy to their first postpartum clinic
visit. The main outcome measure was weight gain during pregnancy categorized
as above the IOM recommendations vs. below or within the IOM recommendations.
Weight Gain Study Results
The intervention significantly decreased the percentage of normal-weight
women who exceeded the IOM recommendations (33 vs. 58%). There was a non-significant
effect in the opposite direction among overweight women (59% of intervention
and 32% of control gained more than recommended). Postpartum weight retention
was strongly related to weight gain during pregnancy.
Weight Gain Study Conclusion
The intervention reduced excessive weight gain during pregnancy among
normal weight women.
Source: International Journal of Obesity
(2002)
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