The effectiveness of healthy lifestyle interventions on weight gain in overweight pregnant women: A cluster-randomized controlled trial.
Sepideh Hajian, Armin Aslani, Parvin Sarbakhsh and 1 others
PMID 33072373WHAT IT FOUND
Overweight pregnant women who received individual diet and exercise counselling gained less weight during pregnancy than those receiving routine prenatal care.
The counselling did not improve gestational diabetes, birth size, caesarean delivery or neonatal jaundice.
Key findings
01Overweight pregnant women who received individual diet and physical activity counselling gained less total weight during pregnancy than those who received routine prenatal care.
02Only 5 women in the intervention group reached the recommended weight gain range, compared with 0 in the comparison group, and this difference was not statistically significant.
03Physical activity, fasting glucose, glucose tolerance, gestational diabetes, neonatal size, caesarean delivery and neonatal jaundice did not differ significantly between the groups.
STILL TO COME
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What it does not show
The trial was open-label, so participants and staff knew who received the counselling. Women were enrolled by convenience sampling from selected health centres, not by individual randomisation. Only 33 women were analysed in each group. The groups differed at baseline in height and husband's education. The intervention combined diet counselling and physical activity training, so the effect cannot be attributed to either component alone. Although total weight gain was lower, only 5 women reached the recommended range, and the difference from the comparison group was not significant. Physical activity did not differ significantly between groups, despite the exercise component. The counselling was delivered by researchers and a nutritionist, so it does not show that nurses can reproduce the effect.
Declared interests
The authors declared no competing interests. The study was funded by Shahid Beheshti University of Medical Sciences.
The easy way to misread this
Do not conclude that lifestyle counselling improved pregnancy or neonatal outcomes. The lower total weight gain did not translate into a significant difference in the number of women reaching the recommended weight gain range, and gestational diabetes, neonatal size, caesarean delivery and jaundice did not differ.