General Obstetrics and Gynecology: Obstetrics
Efficacy of an intervention to prevent excessive gestational weight gain

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Abstract

Objective

This study was undertaken to evaluate the efficacy of an intervention directed at preventing excessive gestational weight gain.

Study design

Healthy pregnant women with normal and overweight early pregnancy body mass index were monitored from early pregnancy until 1-year postpartum. One hundred seventy-nine women in the intervention group had their gestational weight gains monitored by health care providers and also received by-mail patient education. Three hundred eighty-one women formed an historical control group. The proportions in each group gaining more weight in pregnancy than is recommended and retaining more than 2.27 kg at 1-year postpartum were compared using logistic regression analysis.

Results

Low-income women who received the intervention had a significantly reduced risk of excessive gestational weight gain (odds ratio [OR] = 0.41, 95% CI = 0.20-0.81). Overweight women within this income subgroup were at significantly reduced risk of retaining more than 2.27 kg (OR = 0.24, 95% CI = 0.07-0.89).

Conclusion

The intervention appeared to reduce the risk of excessive gestational weight gain only in the low-income subgroup.

Section snippets

Design, population, and sample

The study had a prospective cohort design that used an historical control group. Women were recruited from the population who registered for obstetric care at Bassett Healthcare, a hospital and primary care clinic system serving a 10-county area in upstate New York. For the intervention group, only women with normal (19.8-26.0) and high (26.1-29.0) prepregnancy BMI were recruited. These women entered the study between March 2000 and April 2001. The control group consisted of women with normal

Results

As shown in Table I, the women in the control group and the intervention group did not differ in characteristics often associated with gaining more weight in pregnancy than is recommended: early pregnancy BMI, age, marital status, parity, household income, education, alcohol consumption, or cigarette smoking in pregnancy (all P values > .20). In both groups, about 75% of the women were of normal early pregnancy BMI, 20% were single and had never been married, 41% were having their first baby, and

Comment

Although there was no overall effect of the intervention, among low-income women only 33% in the intervention group gained more than the recommended amount of weight in pregnancy compared with 52% in the control group. Among the higher-income women, there was no difference in the prevalence of excessive gestational weight gain between the intervention and control groups. This finding is important because in our previous research we have found low-income women to be at substantially increased

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    Funding provided by grant DK 57439, Office of Research on Women's Health, and Office of Disease Prevention, National Institutes of Health

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