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      Feasibility and acceptability of regular weighing, setting weight gain limits and providing feedback by community midwives to prevent excess weight gain during pregnancy: randomised controlled trial and qualitative study

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          Abstract

          Background

          Regular weighing in pregnant women is not currently recommended in many countries but has been suggested to prevent excessive gestational weight gain. This study aimed to establish the feasibility and acceptability of incorporating regular weighing, setting maximum weight gain targets and feedback by community midwives.

          Methods

          Low risk pregnant women cared for by eight community midwives were randomised to usual care or usual care plus the intervention at 10–14 weeks of pregnancy. The intervention involved community midwives weighing and plotting weight on a weight gain chart, setting weight gain limit targets, giving brief feedback at each antenatal appointment and encouraging women to weigh themselves weekly between antenatal appointments. Women and midwives were interviewed about their views of the intervention. The focus of the study was on process evaluation.

          Results

          Community midwives referred 123 women and 115 were scheduled for their dating scan within the study period. Of these, 84/115 were approached at their dating scan and 76/84 (90.5 %) randomised. Data showed a modest difference favouring the intervention group in the percentage of women gaining excessive gestational weight (23.5 % versus 29.4 %). The intervention group consistently reported smaller increases in depression and anxiety scores throughout pregnancy compared with usual care. Most women commented the intervention was useful in encouraging them to think about their weight and believed it should be part of routine antenatal care. Community midwives felt the intervention could be implemented within routine care without adding substantially to consultation length, thus not perceived as adding substantially to their workload.

          Conclusions

          The intervention was feasible and acceptable to pregnant women and community midwives and was readily implemented in routine care.

          Trial registration

          ISRCTN81605162

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          Most cited references29

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          The short- and long-term implications of maternal obesity on the mother and her offspring.

          P Catalano, H Ehrenberg (2006)
          Obesity's increasing prevalence has reached epidemic proportions in the USA, with close to one-third of the adult population affected in 2000. Additionally, there is increasing prevalence of obesity in other industrialised areas of the world such as Europe. Of potentially more concern is the potential risks associated with obesity and related metabolic complications in the developing world. The maternal, fetal, peripartum and neonatal complications of obesity in pregnancy have far-reaching implications for both mother and offspring. Of alarming interest is the increasing rate of obesity among adolescents and the cycle of obesity in future generations it portends. The purpose in this review is to briefly review the maternal perinatal morbidities associated with maternal pregravid obesity. Additionally, we will review evidence of both short- and long-term effect of maternal obesity on the in utero environment as it relates to fetal growth, neonatal body composition and adolescent obesity.
          Article 0 comments Cited 226 times – based on 0 reviews     Review now
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            Gestational weight gain and child adiposity at age 3 years.

            Emily Oken, Elsie Taveras, Ken Kleinman … (2007)
            The purpose of this study was to examine the associations of gestational weight gain with child adiposity. Using multivariable regression, we studied associations of total gestational weight gain and weight gain according to 1990 Institute of Medicine guidelines with child outcomes among 1044 mother-child pairs in Project Viva. Greater weight gain was associated with higher child body mass index z-score (0.13 units per 5 kg [95% CI, 0.08, 0.19]), sum of subscapular and triceps skinfold thicknesses (0.26 mm [95% CI, 0.02, 0.51]), and systolic blood pressure (0.60 mm Hg [95% CI, 0.06, 1.13]). Compared with inadequate weight gain (0.17 units [95% CI, 0.01, 0.33]), women with adequate or excessive weight gain had children with higher body mass index z-scores (0.47 [95% CI, 0.37, 0.57] and 0.52 [95% CI, 0.44, 0.61], respectively) and risk of overweight (odds ratios, 3.77 [95% CI: 1.38, 10.27] and 4.35 [95% CI: 1.69, 11.24]). New recommendations for gestational weight gain may be required in this era of epidemic obesity.
            Article 0 comments Cited 185 times – based on 0 reviews     Review now
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              Development and validation of a Pregnancy Physical Activity Questionnaire.

              Lisa Chasan-Taber, Michael Schmidt, Dawn E Roberts … (2004)
              The effect of physical activity during pregnancy on maternal and fetal health remains controversial and studies have yet to identify the optimal dose of physical activity associated with favorable pregnancy outcomes. The aim of this study was to develop and validate a pregnancy physical activity questionnaire (PPAQ). To ascertain the type, duration, and frequency of physical activities performed by pregnant women, three 24-h physical activity recalls were administered to 235 ethnically diverse prenatal care patients at a large tertiary care facility in western Massachusetts. The relative contribution of each activity to between-person variance in energy expenditure was used to establish the list of activities for the PPAQ. The PPAQ is self-administered and asks respondents to report the time spent participating in 32 activities including household/caregiving, occupational, sports/exercise, transportation, and inactivity. To validate the PPAQ, 54 pregnant women completed the PPAQ and then wore a Manufacturing Technology, Inc. actigraph for the following 7 d. At the end of the 7-d period, the PPAQ was repeated. Intraclass correlation coefficients used to measure reproducibility of the PPAQ were 0.78 for total activity, 0.82 for moderate activity, 0.81 for vigorous activity, and ranged from 0.83 for sports/exercise to 0.93 for occupational activity. Spearman correlations between the PPAQ and three published cut points used to classify actigraph data ranged from 0.08 to 0.43 for total activity, 0.25 to 0.34 for vigorous activity, 0.20 to 0.49 for moderate activity, and -0.08 to 0.22 for light-intensity activity. Correlations were higher for sports/exercise and occupational activities as compared to household/caregiving activities. household/caregiving activities. The PPAQ is a reliable instrument of physical activities during pregnancy.
              Article 0 comments Cited 118 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                AJ Daley: 0121 4143762 , a.daley@bham.ac.uk
                K. Jolly: c.b.jolly@bham.ac.uk
                SA Jebb: susan.jebb@phc.ox.ac.uk
                AL Lewis: amanda.lewis@bristol.ac.uk
                S. Clifford: s.clifford@bham.ac.uk
                AK Roalfe: a.k.roalfe@bham.ac.uk
                S. Kenyon: s.kenyon@bham.ac.uk
                P. Aveyard: paul.aveyard@phc.ox.ac.uk
                Journal
                Journal ID (nlm-ta): BMC Obes
                Journal ID (iso-abbrev): BMC Obes
                Title: BMC obesity
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2052-9538
                Publication date (Electronic): 16 September 2015
                Publication date PMC-release: 16 September 2015
                Publication date Collection: 2015
                Volume: 2
                Electronic Location Identifier: 35
                Affiliations
                [ ]Primary Care Clinical Sciences, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT West Midlands
                [ ]Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, B15 2TT West Midlands
                [ ]Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
                [ ]School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS South West England
                Article
                Publisher ID: 61
                DOI: 10.1186/s40608-015-0061-5
                PMC ID: 4572649
                PubMed ID: 26217516
                SO-VID: 713c2800-73e6-4ef1-925f-e21d400f9794
                Copyright © © Daley et al. 2015
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 26 January 2015
                Date accepted : 30 July 2015
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                Keywords: gestational weight gain,regular weighing,weight gain limits,community midwives
                Data availability:
                Keywords: gestational weight gain, regular weighing, weight gain limits, community midwives

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