Are antenatal weight management interventions effective in preventing pre-eclampsia? Systematic review of randomised
Lisa Cuiying Ho1, Karin Anna-Lovisa Saunders1, Deborah Jane Owen1
1Department of Obstetrics and Gynaecology, University of Aberdeen, United Kingdom.
Introduction:
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.
Aims And Objectives:
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.
Conclusion:
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).
