Gestational weight management in underserved mothers in the US

Area of Science:

• Maternal Health
• Public Health Interventions
• Nutritional Science

Background:

• Underserved pregnant individuals face high risks for excessive gestational weight gain and adverse perinatal outcomes.
• The Women, Infants, and Children (WIC) program provides supplemental nutrition assistance and is well-positioned to deliver interventions.
• Integrating e-health interventions into WIC can enhance access to care and complement clinical services for managing gestational weight.

Purpose of the Study:

• To evaluate the effectiveness of a co-developed, multicomponent e-health intervention for gestational weight gain management among pregnant WIC participants.
• To assess the intervention's impact on gestational weight gain guideline attainment, secondary weight outcomes, and adverse perinatal events.

Main Methods:

• A randomized controlled trial involving pregnant WIC participants from 10-16 weeks gestation.
• Participants were assigned to either a multicomponent e-health intervention or usual care.
• Primary outcome was gestational weight gain guideline attainment; secondary outcomes included weight gain, fat mass, and energy balance behaviors.

Main Results:

• The e-health intervention group showed significantly lower study-observed weight gain (-1.4 kg), rate of weight gain (-0.07 kg/wk), deviation from guidelines (-0.05 kg/wk), and fat mass gain (-1.3 kg) compared to usual care.
• Participants in the intervention group also had a lower energy intake (-306 kcals/day).
• Guideline attainment rates were similar between groups (17%), but intervention group showed trends toward fewer preterm births (9% vs. 16%) and NICU admissions (7% vs. 11%).

Conclusions:

• A remotely delivered lifestyle intervention integrated with WIC services effectively reduced gestational weight and fat mass gain.
• This scalable approach demonstrates potential for improving maternal health and addressing disparities by leveraging existing public health infrastructure.