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Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized
Kimberly K Vesco1, Njeri Karanja, Janet C King
1Center 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.
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.
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