Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity.
BACKGROUND
overweight and obesity are growing public health problems and around 13% of women assigned to antenatal health care (AHC) in Sweden have obesity (Body Mass Index, BMI ≥30). The risk of complications during pregnancy and childbirth increase with increasing BMI. Excessive gestational weight gain (GWG) among obese women further increases the risks of adverse pregnancy outcomes. In this pilot-study from AHC in Gothenburg, a co-ordinated project with standardised care, given by midwives and supported by dietitian and aiming at reducing weight gain in obese pregnant women, is evaluated.


OBJECTIVE
to evaluate the effects of a behavioural intervention programme for women with BMI ≥30, with emphasis on nutrition and physical activity, with regards to GWG and effect on weight at the post partum check-up.


METHODS
in the pilot study, the intervention group consisted of the first 50 enrolled obese pregnant women in a large life style project within the AHC in Gothenburg. The control group consisted of 50 obese pregnant women in the same city. The intervention included 60 minutes extra time with the midwife and also offered food discussion group, walking poles and pedometers. The intervention group was prescribed physical activity and could choose from food advice with different content. If needed, the woman was offered referral to the dietitian for a personal meeting. A network was formed with the surrounding community. Outcome measures were GWG, weight change at the postnatal check-up compared with when signing in to antenatal health care, and change in BMI during the same period.


RESULTS
women in the intervention group had a significantly lower GWG (8.6 ± 4.9 kg versus 12.5 ± 5.1 kg; p=0.001) and a significantly lower weight at the postnatal check up versus the first contact with AHC (-0.2 ± 5.7 kg versus +2.0 ± 4.5 kg; p=0.032), as well as a decrease in BMI (-0.04 ± 2.1 versus +0.77 ± 2.0; p=0.037). More women in the intervention than in the control group managed GWG <7 kg [18 (36%) versus 8 (16%); p=0.039].


CONCLUSIONS
obese pregnant women adhering to a standardised life style project in primary care using restricted resources can limit their weight gain during pregnancy, and show less weight retention after pregnancy compared to controls.
Antenatal Health Care, Primary Health Care, Research and Development Unit, Närhälsan, Gothenburg, Region of Västra Götaland, Sweden. Electronic address: karin.haby@vgregion.se.
Karin
K
Haby
Primary Health Care, Närhälsan, Gothenburg, Region of Västra Götaland, Sweden. Electronic address: anna.glantz@vgregion.se.
Anna
A
Glantz
The Sahlgrenska Academy, University of Gothenburg, Institute of Clinical Sciences and Department of Pediatrics, NU Hospital Group, Uddevalla Hospital, Uddevalla, Region of Västra Götaland, Sweden. Electronic address: ragnar.hanas@vgregion.se.
Ragnar
R
Hanas
The Sahlgrenska Academy, University of Gothenburg, Primary Health Care, Research and Development Unit, Närhälsan, Gothenburg, Region of Västra Götaland, Sweden. Electronic address: asa.premberg@vgregion.se.
Åsa
Å
Premberg
D000328:Adult; D003376:Counseling; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery; D009765:Obesity / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D013548:Sweden; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
Intervention; Lifestyle; Maternity Health Care; Obesity; Pregnancy