title: Are antenatal weight management interventions effective in preventing pre-eclampsia? Systematic review of randomised control trials.
abstract: BACKGROUND
  Pre-eclampsia, defined as the development of hypertension and proteinuria after 20weeks gestation, carries significant maternal and foetal risk. Pre-pregnancy BMI is the most useful predictor of pre-eclampsia. As the prevalence of obesity increases, prevention of pre-eclampsia by weight management strategies needs to be trialed.
  
  
  OBJECTIVE
  To review the randomised controlled trials studying clinical effectiveness of antenatal weight management interventions compared to routine care in decreasing the incidence of pre-eclampsia in women with BMI 26kg/m(2) or greater.
  
  
  METHODS
  Electronic bibliographic databases were searched using a systematic search strategy to identify relevant trials. All trials involving weight management during pregnancy were considered. Using pre-determined inclusion criteria, six trials were included in this review and were independently assessed using standardised evaluation criteria.
  
  
  RESULTS
  Three studies found a significant difference in gestational weight gain; amongst the intervention groups, the smallest was 5.0kg, whereas the largest was 13.6kg. In sub-group analysis, one trial found a significant difference in the incidence of pre-eclampsia between adherent (2/90) and non-adherent participants (5/26). However, no significant difference was found in the overall incidence of pre-eclampsia across all intervention and control groups.
  
  
  CONCLUSIONS
  There was no evidence to suggest that antenatal weight management interventions were effective in reducing the incidence of pre-eclampsia in women with a BMI⩾26kg/m(2).
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aberdeen, United Kingdom.
authors.forename: Lisa Cuiying
authors.initials: LC
authors.lastname: Ho
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aberdeen, United Kingdom.
authors.forename: Karin Anna-Lovisa
authors.initials: KA
authors.lastname: Saunders
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aberdeen, United Kingdom.
authors.forename: Deborah Jane
authors.initials: DJ
authors.lastname: Owen
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aberdeen, United Kingdom.
authors.forename: Umi Nursheila Nur
authors.initials: UN
authors.lastname: Ibrahim
authors.affiliation: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, United Kingdom. Electronic address: sohinee.bhattacharya@abdn.ac.uk.
authors.forename: Sohinee
authors.initials: S
authors.lastname: Bhattacharya
keywords: Body Mass Index; Obesity; Overweight; Pre-eclampsia; Systematic review