Article

The effect of a counselling intervention on weight changes during and after pregnancy: A randomised trial

Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands Medisch Centrum Jan van Goyen, Department of Gynaecology & Obstetrics, Amsterdam, The Netherlands Body@Work, Research Centre on Physical Activity, Work and Health, TNO-VUmc, VU University Medical Centre, Amsterdam, The Netherlands Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.86). 11/2012; 120(1). DOI: 10.1111/1471-0528.12014
Source: PubMed

ABSTRACT Objectives To evaluate the effects of a counselling intervention on excessive weight gain during pregnancy and postpartum weight retention.
Design The New Life(style) study was a randomised trial with a control group (n = 113) and an intervention group (n = 106).
Setting Midwife practices in the Netherlands.
Population Women with a healthy pregnancy, expecting their first baby.
Methods The intervention consisted of four face-to-face counselling sessions about weight, physical activity and diet during pregnancy, and one session by telephone after delivery.
Main outcome measures Weight was objectively assessed at 15, 25 and 35 weeks of gestation, and again at 8, 26 and 52 weeks postpartum. In regression models, the intervention effect on gestational weight gain and postpartum weight retention was assessed.
Results Women gained on average 11.3 kg (SD 3.7 kg) from early to late pregnancy. Women were 1.0 kg (SD 5.3 kg) lighter at 52 weeks postpartum compared with early pregnancy. The intervention had no effect on gestational weight gain (B = −0.05; 95% CI −1.10 to 1.00) or postpartum weight (B = 0.94; 95% CI −2.41 to 0.53) in the total study group. In a subgroup of overweight and obese women (n = 47), a favourable trend on all outcomes was observed, but none of the differences were statistically significant.
Conclusion The lifestyle counselling intervention evaluated in this study did not have an effect on excessive weight gain or postpartum weight retention. Our findings for overweight and obese women need to be confirmed in a larger, well-designed randomised trial.

Download full-text

Full-text

Available from: Jaap Seidell, Sep 15, 2014
0 Followers
 · 
233 Views
 · 
21 Downloads
  • Source
    • "We performed a secondary analysis of data of the randomized controlled trials performed by Althuizen et al. [21] (ISRCTN85313483) and Oostdam et al. [22] [23] (NTR1139). The interventions evaluated in the two trials were not effective in reducing gestational weight gain in the total study population [23] [24]. Data from both trials were combined and analysed as a cohort, as the study design and procedures were similar for both trials. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To evaluate the relationship of physical activity (PA) and sedentary behaviour with gestational weight gain (GWG) and birth weight. Design. Combined data from two prospective studies: (1) nulliparous pregnant women without BMI restrictions and (2) overweight and obese pregnant women at risk for gestational diabetes. Methods. Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32-35 weeks of gestation. The association between time spent in moderate-to-vigorous PA (MVPA) and in sedentary activities with GWG and birth weight was determined. Main outcome measures were GWG between 15 and 32 weeks of gestation, average GWG per week, and birth weight. Results. We studied 111 women. Early in pregnancy, 32% of women spent ≥30 minutes/day in at least moderate PA versus 12% in late pregnancy. No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight. Conclusions. We found no relation between MVPA and sedentary behaviour with GWG or birth weight. The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA, as there seems to be no adverse effect on birth weight and maintaining PA increases overall health.
    Journal of pregnancy 09/2014; 2014:567379. DOI:10.1155/2014/567379
  • [Show abstract] [Hide abstract]
    ABSTRACT: Excessive weight gain during pregnancy is a risk factor for postpartum weight retention and future weight gain and obesity. Whether a behavioral intervention in pregnancy can reduce long-term weight retention is unknown. This randomized trial tested whether a low-intensity behavioral intervention to prevent excessive gestational weight gain could increase the proportion of women who returned to prepregnancy weight by 12 mo postpartum. Women (n = 401, 13.5 wk of gestation, 50% normal weight, 50% overweight/obese) were randomly assigned into an intervention or control group; 79% completed the 12-mo assessment. The telephone-based intervention targeted gestational weight gain, healthy eating, and exercise and was discontinued at delivery. In modified intent-to-treat analyses that excluded women with miscarriages (n = 6), gestational diabetes (n = 32), or subsequent pregnancies (n = 32), the intervention had no significant effect on the odds of achieving prepregnancy weight at 12 mo postpartum (n = 331; 35.4% compared with 28.1%; P = 0.18). Completer analyses suggested that the intervention tended to increase the percentages of women who reached prepregnancy weight (n = 261; 45.3% compared with 35.3%; P = 0.09) and significantly reduced the magnitude of postpartum weight retained (1.4 ± 6.3 compared with 3.0 ± 5.7 kg; P = 0.046) at 12 mo. Women in the intervention group reported higher dietary restraint through 6 mo postpartum (P = 0.023) and more frequent self-monitoring of body weight (P < 0.02 for all) throughout the study. A low-intensity behavioral intervention in pregnancy can reduce 12-mo postpartum weight retention and improve dietary restraint and self-weighing in study completers. Future research is needed to test the long-term effects of more intensive behavioral interventions in pregnancy. This trial was registered at clinicaltrials.gov as NCT01117961.
    American Journal of Clinical Nutrition 11/2013; 99(2). DOI:10.3945/ajcn.113.070151 · 6.92 Impact Factor
  • 01/2014; 34(13):1-7. DOI:10.1097/01.PGO.0000451414.06880.56
Show more