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Limiting postpartum weight retention through early antenatal intervention: the HeLP-her randomised controlled trial.

Harrison CL, Lombard CB, Teede HJ - Int J Behav Nutr Phys Act (2014)

Bottom Line: By 6 weeks postpartum, weight change in the control group was significantly higher than the intervention group with a between group difference of 1.45 ± 5.1 kg (95% CI: -2.86,-0.02; p < 0.05) overall, with a greater difference in weight found in overweight, but not obese women.Other factors related to weight including physical activity, did not differ between groups.A low intensity intervention, integrated with standard antenatal care is effective in limiting postpartum weight retention.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Pregnancy is a recognised high risk period for excessive weight gain, contributing to postpartum weight retention and obesity development long-term. We aimed to reduce postpartum weight retention following a low-intensity, self-management intervention integrated with routine antenatal care during pregnancy.

Methods: 228 women at increased risk of gestational diabetes, <15 weeks gestation were randomised to intervention (4 self-management sessions) or control (generic health information). Outcomes, collected at baseline and 6 weeks postpartum, included anthropometrics (weight and height), physical activity (pedometer) and questionnaires (health behaviours).

Results: Mean age (32.3 ± 4.7 and 31.7 ± 4.4 years) and body mass index (30.4 ± 5.6 and 30.3 ± 5.9 kg/m2) were similar between intervention and control groups, respectively at baseline. By 6 weeks postpartum, weight change in the control group was significantly higher than the intervention group with a between group difference of 1.45 ± 5.1 kg (95% CI: -2.86,-0.02; p < 0.05) overall, with a greater difference in weight found in overweight, but not obese women. Intervention group allocation, higher baseline BMI, GDM diagnosis, country of birth and higher age were all independent predictors of lower weight retention at 6 weeks postpartum on multivariable linear regression. Other factors related to weight including physical activity, did not differ between groups.

Conclusions: A low intensity intervention, integrated with standard antenatal care is effective in limiting postpartum weight retention. Implementation research is now required for scale-up to optimise antenatal health care.

Trial registration: Australian New Zealand Clinical Trial Registry Number: ACTRN12608000233325. Registered 7/5/2008.

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CONSORT diagram.
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Fig1: CONSORT diagram.

Mentions: In total, 1331 women were identified at booking visits by midwives as being at risk for GDM using a simple validated screening tool and were invited by an invitation flyer and follow-up phone call to participate in the trial. Of these, 329 expressed interest (25% response rate) and 228 were recruited and randomised with 121 women allocated to intervention and 107 to control at baseline (summarised previously [17]; CONSORT information provided in Figure 1). Mean gestation of women at baseline was 14 ± 0.8 weeks [17]. Of the women allocated to the intervention, 95% attended session two, 89% session three and 93% session four. At 6 weeks postpartum, 104 women from the intervention group and 98 from the control group completed outcome measures, with an overall attrition rate of 11.4%, including lost to follow up and pre-term births defined as ≤36 weeks gestation.Figure 1


Limiting postpartum weight retention through early antenatal intervention: the HeLP-her randomised controlled trial.

Harrison CL, Lombard CB, Teede HJ - Int J Behav Nutr Phys Act (2014)

CONSORT diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4221718&req=5

Fig1: CONSORT diagram.
Mentions: In total, 1331 women were identified at booking visits by midwives as being at risk for GDM using a simple validated screening tool and were invited by an invitation flyer and follow-up phone call to participate in the trial. Of these, 329 expressed interest (25% response rate) and 228 were recruited and randomised with 121 women allocated to intervention and 107 to control at baseline (summarised previously [17]; CONSORT information provided in Figure 1). Mean gestation of women at baseline was 14 ± 0.8 weeks [17]. Of the women allocated to the intervention, 95% attended session two, 89% session three and 93% session four. At 6 weeks postpartum, 104 women from the intervention group and 98 from the control group completed outcome measures, with an overall attrition rate of 11.4%, including lost to follow up and pre-term births defined as ≤36 weeks gestation.Figure 1

Bottom Line: By 6 weeks postpartum, weight change in the control group was significantly higher than the intervention group with a between group difference of 1.45 ± 5.1 kg (95% CI: -2.86,-0.02; p < 0.05) overall, with a greater difference in weight found in overweight, but not obese women.Other factors related to weight including physical activity, did not differ between groups.A low intensity intervention, integrated with standard antenatal care is effective in limiting postpartum weight retention.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Pregnancy is a recognised high risk period for excessive weight gain, contributing to postpartum weight retention and obesity development long-term. We aimed to reduce postpartum weight retention following a low-intensity, self-management intervention integrated with routine antenatal care during pregnancy.

Methods: 228 women at increased risk of gestational diabetes, <15 weeks gestation were randomised to intervention (4 self-management sessions) or control (generic health information). Outcomes, collected at baseline and 6 weeks postpartum, included anthropometrics (weight and height), physical activity (pedometer) and questionnaires (health behaviours).

Results: Mean age (32.3 ± 4.7 and 31.7 ± 4.4 years) and body mass index (30.4 ± 5.6 and 30.3 ± 5.9 kg/m2) were similar between intervention and control groups, respectively at baseline. By 6 weeks postpartum, weight change in the control group was significantly higher than the intervention group with a between group difference of 1.45 ± 5.1 kg (95% CI: -2.86,-0.02; p < 0.05) overall, with a greater difference in weight found in overweight, but not obese women. Intervention group allocation, higher baseline BMI, GDM diagnosis, country of birth and higher age were all independent predictors of lower weight retention at 6 weeks postpartum on multivariable linear regression. Other factors related to weight including physical activity, did not differ between groups.

Conclusions: A low intensity intervention, integrated with standard antenatal care is effective in limiting postpartum weight retention. Implementation research is now required for scale-up to optimise antenatal health care.

Trial registration: Australian New Zealand Clinical Trial Registry Number: ACTRN12608000233325. Registered 7/5/2008.

Show MeSH
Related in: MedlinePlus