Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence.
Nicole S Carlson, Sharon Lynn Leslie, Alexis Dunn
PMID 29758115WHAT IT FOUND
Lifestyle interventions often fail to improve outcomes for pregnant women with obesity, but exercise programs do reduce gestational weight gain and diabetes risk.
Screening for sleep apnea and depression is critical, as these conditions are common and linked to poor birth outcomes.
Key findings
01Supervised exercise programs during pregnancy reduced gestational weight gain and the incidence of gestational diabetes and preterm birth in women with obesity, without increasing adverse effects.
02Dietary and lifestyle counseling interventions frequently showed no benefit for women with obesity, particularly compared to women with normal or overweight BMIs.
03Obstructive sleep apnea is common in pregnant women with obesity and is associated with stillbirth, emergency cesarean birth, and neonatal complications, yet it is often missed by clinicians.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review excluded case reports and lower-level evidence, which may have omitted some qualitative insights. Heterogeneity in study designs and interventions makes direct comparison difficult. Adherence to lifestyle interventions was often poor in the included trials, which may affect the generalizability of the null findings for diet and counseling.
Declared interests
The authors have no conflicts of interest to disclose. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not conclude that all lifestyle interventions are ineffective for women with obesity. While dietary counseling alone often failed, supervised exercise programs demonstrated clear benefits in reducing gestational weight gain and diabetes risk. Additionally, do not rely on the STOP-Bang questionnaire alone to rule out sleep apnea in this population, as its sensitivity is low.