title: Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial.
abstract: OBJECTIVE
  Observational studies suggest that minimal gestational weight gain (GWG) may optimize pregnancy outcomes for obese women. This trial tested the efficacy of a group-based weight management intervention for limiting GWG among obese women.
  
  
  METHODS
  One hundred and fourteen obese women (BMI [mean ± SD] 36.7 ± 4.9 kg/m(2) ) were randomized between 7 and 21 weeks' (14.9 ± 2.6) gestation to intervention (n = 56) or usual care control conditions (n = 58). The intervention included individualized calorie goals, advice to maintain weight within 3% of randomization and follow the Dietary Approaches to Stop Hypertension dietary pattern without sodium restriction, and attendance at weekly group meetings until delivery. Control participants received one-time dietary advice. Our three main outcomes were maternal weight change from randomization to 2 weeks postpartum and from randomization to 34 weeks gestation, and newborn large-for-gestational age (birth weight >90th percentile, LGA).
  
  
  RESULTS
  Intervention participants gained less weight from randomization to 34 weeks gestation (5.0 vs. 8.4 kg, mean difference = -3.4 kg, 95% CI [-5.1-1.8]), and from randomization to 2 weeks postpartum (-2.6 vs. +1.2 kg, mean difference = -3.8 kg, 95% CI [-5.9-1.7]). They also had a lower proportion of LGA babies (9 vs. 26%, odds ratio = 0.28, 95% CI [0.09-0.84]).
  
  
  CONCLUSIONS
  The intervention resulted in lower GWG and lower prevalence of LGA newborns.
authors.affiliation: Center for Health Research, Kaiser Permanente, Northwest, 3800 N. Interstate Avenue, Portland, Oregon, 97227, USA; Department of Obstetrics and Gynecology, Kaiser Permanente, Northwest, 500 NE Multnomah Street, Portland, Oregon, 97232, USA.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.forename: Njeri
authors.initials: N
authors.lastname: Karanja
authors.forename: Janet C
authors.initials: JC
authors.lastname: King
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.forename: Michael C
authors.initials: MC
authors.lastname: Leo
authors.forename: Nancy
authors.initials: N
authors.lastname: Perrin
authors.forename: Cindy T
authors.initials: CT
authors.lastname: McEvoy
authors.forename: Cara L
authors.initials: CL
authors.lastname: Eckhardt
authors.forename: K Sabina
authors.initials: KS
authors.lastname: Smith
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
mesh_terms: D000328:Adult; D001724:Birth Weight; D003376:Counseling; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006126:Group Processes; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000517:prevention & control; D007231:Infant, Newborn; D009765:Obesity / Q000178:diet therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000178:diet therapy* / Q000517:prevention & control; D012657:Self-Help Groups; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult