A Behavioral Intervention to Reduce Excessive Gestational Weight Gain
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A Behavioral Intervention to Reduce Excessive Gestational Weight Gain Rebecca A. Krukowski1 • Delia West2 • Marisha DiCarlo3 • Kartik Shankar4,5 Mario A. Cleves4,5 • Eric Tedford6 • Aline Andres4,5
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Ó Springer Science+Business Media New York 2016
Abstract Objectives Excessive gestational weight gain (GWG) is a key modifiable risk factor for negative maternal and child health. We examined the efficacy of a behavioral intervention in preventing excessive GWG. Methods 230 pregnant women (87.4 % Caucasian, mean age = 29.2 years; second parity) participated in the longitudinal Glowing study (clinicaltrial.gov #NCT01131117), which included six intervention sessions focused on GWG. To determine the efficacy of the intervention in comparison to usual care, participants were compared to a matched contemporary cohort group from the Arkansas Pregnancy Risk Assessment Monitoring Survey (PRAMS). Results Participants attended 98 % of intervention sessions. Mean GWG for the Glowing participants was 12.7 ± 2.7 kg for normal weight women, 12.4 ± 4.9 kg for overweight women, and 9.0 ± 4.2 kg for class 1 obese women. Mean GWG was significantly lower for normal weight and class 1 obese
Glowing participants compared to the PRAMS respondents. Similarly, among those who gained excessively, normal weight and class 1 obese Glowing participants had a significantly smaller mean weight gain above the guidelines in comparison to PRAMS participants. There was no significant difference in the overall proportion of the Glowing participants and the proportion of matched PRAMS respondents who gained in excess of the Institute of Medicine GWG guidelines. Conclusions for Practice This behavioral intervention was well-accepted and attenuated GWG among normal weight and class 1 obese women, compared to matched participants. Nevertheless, a more intensive intervention may be necessary to help women achieve GWG within the Institute of Medicine’s guidelines.
& Rebecca A. Krukowski [email protected]
Significance
1
Center for Population Sciences, Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
2
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
3
Office of Health Communications, Arkansas Department of Health, Little Rock, AR, USA
4
Arkansas Children’s Nutrition Center & Arkansas Children’s Research Institute, Little Rock, AR, USA
5
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
6
Health Statistics Branch, Center for Public Health Practice, Arkansas Department of Health, Slot 19, 4815 West Markham St., Little Rock, AR 72205, USA
Keywords Gestational weight gain Obesity Pregnancy Behavioral intervention
What is already known on this subject? Excessive GWG is clearly associated with negative maternal and child health; however, the optimal design and intervention intensity for minimizing excessive GWG is not yet known. What this study adds? This behavior
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