"Excess weight gain during pregnancy increases the risk for developing gestational diabetes and problems with high blood pressure during pregnancy," Phipps said. "Obesity is associated with an increased risk for cesarean delivery, fetal growth problems, and premature birth. In addition to adding to the difficulty of losing weight post partum, excess weight gain during pregnancy can have long-term health consequences for both the mother and the infant."
Fit for delivery
The team devised an intervention that they hoped would be effective, but also "low-intensity" so that clinicians and patients could stick with it. Patients randomly selected to receive the intervention went to an initial, face-to-face meeting with an interventionist who coached them on topics such as what constitutes healthy pregnancy weight gain, the need for physical activity such as walking, calorie goals, reducing fat intake and daily self-monitoring. Women received scales, pedometers and forms for recording what they ate.
From there, the intervention proceeded exclusively via the mail and by phone with weekly reminder postcards and three calls from a dietitian to offer encouragement. After each visit to their doctor's office, the women would also receive graphs showing them their weight gain compared to what would be ideal based on health guidelines. Women who were gaining too much or too little received additional follow-up coaching calls from the study dietitian.
Among normal-weight women who received the intervention, 40.2 percent gained more than the IOM recommendations, but among comparable women who did not receive the intervention, 52.1 percent gained too much. Six months after delivery, 35.6
|Contact: David Orenstein|