With Counseling, Obese Women Gained Less Weight in Pregnancy

Nutrition and exercise counseling kept obese women from gaining too much weight and resulted in fewer pregnancy complications

(RxWiki News) Obese women who become pregnant face many challenges, but researchers have found that a little help can go a long way.

Obese women who stuck to an intensive nutrition and exercise program in the first three months of pregnancy did not gain as much weight and had healthier pregnancies than women who were not in the program or women who did not follow the advice of the program.

"If you are obese and pregnant, speak to your OB-GYN about a healthy weight goal."

Li Guanghui, PhD, MD, of the Beijing Obstetrics and Gynecology Hospital in China, led this study.

There were 213 women enrolled in the study at six to 12 weeks gestation (the first trimester of pregnancy). All of the women were obese, and they were randomly assigned to either the standard care group (72 women) or the intervention group (141 women).

All of the women were seen by obstetricians.

For standard care, the women had one group session with a dietitian who talked about proper nutrition, physical activity and how much weight gain was recommended during pregnancy.

For the intervention group, there was one group session with a dietitian, followed by individual counseling sessions. Women in this group recorded what they ate and their weekly weight gain, as well as how much they exercised. The plan was modified as needed according to how well each woman did.

In the intervention group, 68 women adhered to the advice they received, and 73 did not.

Women who complied with the instructions they received gained an average of 24 pounds for their pregnancy. Non-adherent women in the intervention group and women in the standard care group gained a little more than 31 pounds on average.

No one in the adherent group developed preeclampsia, which is a serious condition that can occur during pregnancy. In preeclampsia, the woman develops high blood pressure and may have damage to her kidneys, resulting in protein in her urine. The researchers found that 2.7 percent of women who were non-adherent in the intervention group and 6.9 percent of women in the standard care group developed preeclampsia.

Women in the intervention group who followed the advice had fewer large babies.

Babies with a condition called macrosomia weigh 8 pounds 13 ounces or more at birth. The rate of macrosomia in babies of women in the intervention group who followed instructions was 7.4 percent, compared with 27.4 percent among the babies of women who were not adherent and 25 percent in the babies of women in the standard care group.

Furthermore, 10.3 percent of babies of mothers in the adherent group were large-for-gestational-age (large at birth for how many weeks pregnant their moms were), while this was true of 32.9 percent of babies in the non-adherent group and 25 percent of babies in the standard care group.

Andre F. Hall, MD, of Birth and Women’s Care in Fayetteville, North Carolina, told dailyRx News that this study shows that lifestyle changes can improve health for women who are obese.

"Obesity prior to pregnancy leads to obesity in pregnancy. There are a large number of medical complications that are increased when patients are obese,” Dr. Hall said. “This study shows that lifestyle changes along with diet modification can lead to improved pregnancy outcomes later in pregnancy. These lifestyle changes if maintained beyond pregnancy will also lead to an overall healthier person long term.”

Dr. Li’s study was presented June 21 at the joint meeting of the International Society of Endocrinology and the Endocrine Society in Chicago. It has not yet been peer-reviewed.

Funding for the project came from the Beijing Health Bureau and the Ministry of Health, People’s Republic of China.

Review Date: 
June 26, 2014