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: 3.45). 11/2012; 120(1). DOI: 10.1111/1471-0528.12014
Source: PubMed


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.

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Available from: Jaap Seidell, Sep 15, 2014
    • "weeks, SD = 2.7, Range = 31–42), a rate of GWG was calculated, computed as total GWG (calculated by subtracting self-reported prepregnancy weight from final pregnancy weight) divided by weeks gestation at last weight measurement and then multiplied by 40 weeks to provide a figure for total GWG that was adjusted for weeks gestation – 'adjusted total GWG'. This technique has been previously used in GWG interventions (Althuizen, van der Wijden, van Mechelen, Seidell, & vanPoppel, 2013;Ashley-Martin & Woolcott, 2014). Total GWG was also classified according to the IOM GWG (which were originally released in 2009, and again in 2013) recommendations for each pre-pregnancy BMI category (Rasmussen & Yaktine, 2009); women gaining above, within, of below these recommendations were classified with excessive, adequate, or inadequate GWG, respectively. "

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    • "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. "
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    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 as NCT01117961.
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