Intervention during pregnancy to reduce excessive gestational weight gain—a randomised controlled trial

Abstract

Objective To evaluate if a feasible, low‐cost intervention could decrease the percentage of women gaining weight above the Institute of Medicine ( IOM ) recommendations on gestational weight gain ( GWG ) compared with standard maternity care. Design A randomised controlled interventional design. Setting Antenatal clinics ( n = 14) in Örebro county, Sweden, participated. Population Healthy women with a body mass index ( BMI ) ≥19 kg/m 2 , age ≥18 years and adequate knowledge of Swedish language who signed in for maternity care at ≤16 weeks of gestation. Methods Standard care was compared with a composite intervention consisting of education on recommended GWG according to IOM , application of personalised weight graph, formalised prescription of exercise and regular monitoring of GWG at every antenatal visit. Outcome The proportion of women gaining weight above IOM guidelines (1990) and mean GWG (kg) was compared between groups. Results In all, 445 women were randomised and 374 women remained for analysis after delivery. A majority of the women analysed were normal weight (72%). The intervention reduced the proportion of women who exceeded the IOM guidelines (41.1% versus 50.0%). The reduction was, however, not statistically significant ( P = 0.086). Mean GWG was significantly lower among women receiving the intervention, 14.2 kg ( SD 4.4) versus 15.3 kg ( SD 5.4) in the standard care group ( P = 0.029). Conclusions The low‐cost intervention programme tested did significantly reduce the mean GWG but the proportion of women who exceeded the IOM recommendations for GWG was not significantly lower. ClinicalTrials.gov Id NCT00451425 http://clinicaltrials.gov