title: Trial for Reducing Weight Retention in New Mums: a randomised controlled trial evaluating a low intensity, postpartum weight management programme.
abstract: BACKGROUND
  Failure to return to pregnancy weight by 6 months postpartum is associated with long-term obesity, as well as adverse health outcomes. This research evaluated a postpartum weight management programme for women with a body mass index (BMI) > 25 kg m(-2) that combined behaviour change principles and a low-intensity delivery format with postpartum nutrition information.
  
  
  METHODS
  Women were randomised at 24-28 weeks to control (supported care; SC) or intervention (enhanced care; EC) groups, stratified by BMI cohort. At 36 weeks of gestation, SC women received a 'nutrition for breastfeeding' resource and EC women received a nutrition assessment and goal-setting session about post-natal nutrition, plus a 6-month correspondence intervention requiring return of self-monitoring sheets. Weight change, anthropometry, diet, physical activity, breastfeeding, fasting glucose and insulin measures were assessed at 6 weeks and 6 months postpartum.
  
  
  RESULTS
  Seventy-seven percent (40 EC and 41 SC) of the 105 women approached were recruited; 36 EC and 35 SC women received a programme and 66.7% and 48.6% completed the study, respectively. No significant differences were observed between any outcomes. Median [interquartile range (IQR)] weight change was EC: -1.1 (9.5) kg versus SC: -1.1 (7.5) kg (6 weeks to 6 months) and EC: +1.0 (8.7) kg versus SC: +2.3 (9) kg (prepregnancy to 6 months). Intervention women breastfed for half a month longer than control women (180 versus 164 days; P = 0.10). An average of 2.3 out of six activity sheets per participant was returned.
  
  
  CONCLUSIONS
  Despite low intervention engagement, the high retention rate suggests this remains an area of interest to women. Future strategies must facilitate women's engagement, be individually tailored, and include features that support behaviour change to decrease women's risk of chronic health issues.
authors.affiliation: Mater Research, Mothers and Babies Theme, South Brisbane, QLD, Australia; Department of Nutrition and Dietetics, Mater Mothers' Hospital, South Brisbane, QLD, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Wilkinson
authors.forename: P
authors.initials: P
authors.lastname: van der Pligt
authors.forename: K S
authors.initials: KS
authors.lastname: Gibbons
authors.forename: H D
authors.initials: HD
authors.lastname: McIntyre
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D004032:Diet; D005260:Female; D015438:Health Behavior; D006801:Humans; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D010352:Patient Dropouts; D011181:Postnatal Care; D049590:Postpartum Period; D011247:Pregnancy; D015397:Program Evaluation; D015431:Weight Loss; D055815:Young Adult
keywords: behaviour change; health service delivery; obesity; overweight; postpartum; weight management