Obesity, Reproduction and Pregnancy

ORP: Structured Programs and Interventions (2014)

• Intervention
  In overweight and obese women who become pregnant, what is the impact of a structured weight management program in gestational weight gain?

  • Conclusion

    Among overweight and obese women, gestational weight gain appears to be controlled by a lifestyle intervention approach to weight management. Limited evidence supports any combination of behavioral counseling, weight monitoring, diet and physical activity as weight management methods to control excessive gestational weight gain (GWG). Physical activity interventions independent of other weight management strategies did not appear to influence GWG.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In overweight and obese women who become pregnant, what is the impact of a structured weight management program in gestational weight gain?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: A randomized control trial. Obstetrics & Gynecology. 2009; 113 (2p 1): 305-312. 
      •  Guelinckx I, Devlieger R, Mullie P, Vansant G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: A randomized controlled trial. Am J Clin Nutr. 2010; 91: 373–380.
      • Hopkins SA, Baldi JC, Cutfield WS, McCowan L, Hoffman PL. Excercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. J Clin Endocrinol Metab.  2010 May; 95(5): 2,080-2,088.
      • Jeffries K, Shub A, Walker SP, Hiscock R, Permezel M. Reducing excessive weight gain in pregnancy: A randomised controlled trial. Med J Aust. 2009:Oct 19; 191(8): 429-433.   
      • Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes. 2002; 26(11): 1,494-1,502.  
      • Quinlivan JA, Lam LT, Fisher J. A randomised trial of a four-step multi-disciplinary approach to the antenatal care of obese pregnant women. Aust N Z J Obstet Gynaecol. 2011; 51: 141-146.
      • Thornton YS, Smarkola C, Kopacz SM, Ishoof SB. Perinatal outcomes in nutritionally monitored obese pregnant women: A randomized clinical trial.J Natl Med Assoc. 2009 Jun; 101(6): 569-577.  
      • Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes. 2008; 32: 495-501.
  • Search Plan and Results: ORP: Weight Management for Gestational Weight Gain 2013
     
  In post-weight loss surgery (WLS) females who become pregnant, what is the impact of nutrition intervention on gestational weight gain?

  • Conclusion

    No evidence was identified to evaluate the impact of nutrition intervention on gestational weight gain in post-WLS females who become pregnant.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: ORP: Post-WLS Nutrition Intervention for Gestational Weight Gain 2013