Advise group-based weight interventions for obese pregnant patients

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For obese pregnant women, group-based weight management interventions are effective in limiting gestational weight gain during pregnancy, indicate recent study results.


“Of weight management trials conducted among obese, nondiabetic, pregnant women, most have used interventions with less frequent direct participant contact, and few have been successful,” noted Kimberly K. Vesco, MD, MPH, of the Center for Health Research in Portland, Oregon, and colleagues in Obesity.


To test the efficacy of group-based weight management interventions, the investigators randomly assigned 114 obese female patients between 7 and 21 weeks’ gestation to intervention (n=56) or usual care (n=58). The intervention included individualized calorie goals, advice to maintain weight, and attendance in weekly group meetings until delivery. Control participants received one-time dietary advice.


The scientists tracked three main outcomes: maternal weight change from randomization to two weeks’ postpartum, from randomization to 34 weeks’ gestation, and newborn large-for-gestational-age (birth weight <90th percentile).


Intervention patients gained less weight from randomization to 34 weeks’ gestation (5.0 kg versus 8.4 kg, mean difference = -3.4 kg; 95% CI: -5.1-1.8) and from randomization to two weeks’ postpartum (-2.6 versus +1.2 kg, mean difference = -3.8 kg; 95% CI: -5.9-1.7). Of the intervention patients, only 9% had of large-for-gestational-age babies, compared with 26% of women in the control group (odds ratio, 0.28; 95% CI: 0.09-0.84).


 “Frequent contacts and self-monitoring (keeping food and activity records, having weekly weigh-ins, and plotting weight gain), provide accountability and are among the most important components of behavioral weight management,” wrote the researchers.


“These components, which were included in our study, likely contributed to the intervention participants' success.”

Obese women who were enrolled in a behavioral, group-based weight management program lost more weight and had fewer large-for-gestational-age newborns.

Advise group-based weight interventions for obese pregnant patients
Advise group-based weight interventions for obese pregnant patients

In the United States, about 30% of women of reproductive age are obese and over 50% of obese women gain more weight during pregnancy than recommended by the Institute of Medicine (IOM).

Excessive gestational weight gain (GWG) increases the risk of macrosomia (birth weight >4000 g), large for gestational age (birth weight >90th percentile), higher child BMI z-scores, and increased body fat and elevated systolic blood pressure in children at age 3 years . Excessive GWG is also associated with both short- and long-term maternal weight retention.

How to reduce weight gain among obese pregnant women has been unclear. In nonpregnant adults, the most effective weight loss and weight maintenance interventions have employed dietary counseling and weekly participant contact.

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