Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial

Objective: Lifestyle intervention could help obese pregnant women to limit their weight gain during pregnancy and improve their psychological comfort, but has not yet been evaluated in randomized controlled trials. We evaluated whether a targeted antenatal lifestyle intervention programme for obese...

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Published in:	International Journal of Obesity Vol. 37; no. 6; pp. 814 - 821
Main Authors:	Bogaerts, A F L, Devlieger, R, Nuyts, E, Witters, I, Gyselaers, W, Van den Bergh, B R H
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 01-06-2013 Nature Publishing Group
Subjects:	Adult Analysis Anxiety Anxiety - epidemiology Anxiety - prevention & control Belgium - epidemiology Biological and medical sciences Body Mass Index Brochures Clinical trials Depression - epidemiology Depression - prevention & control Depression, Mental Design Epidemiology Female Gestational diabetes Health Knowledge, Attitudes, Practice Health Promotion and Disease Prevention Hospitals Humans Internal Medicine Intervention Life Style Lifestyles Longitudinal Studies Medical ethics Medical sciences Medicine Medicine & Public Health Mental depression Mental health Metabolic Diseases Miscellaneous Motivation Obesity Obesity - epidemiology Obesity - prevention & control Obesity - psychology Obesity - therapy Obstetrics original-article Patient Education as Topic Physiological aspects Pregnancy Pregnancy Complications - epidemiology Pregnancy Complications - prevention & control Pregnancy Complications - psychology Pregnancy Complications - therapy Pregnant women Prenatal Care - methods Prevalence Prevention Psychological aspects Public Health Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Risk Reduction Behavior Surveys and Questionnaires Weight Gain Womens health Belgium anxiety gestational weight gain lifestyle intervention pregnancy randomized controlled trial Human Affect affectivity Obesity Nutrition Nutrition disorder Mental health Anxiety disorder Metabolic diseases Weight gain Pregnancy Randomization Randomised controlled trial Clinical trial Female Anxiety Woman Nutritional status Public health Life style
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Summary:	Objective: Lifestyle intervention could help obese pregnant women to limit their weight gain during pregnancy and improve their psychological comfort, but has not yet been evaluated in randomized controlled trials. We evaluated whether a targeted antenatal lifestyle intervention programme for obese pregnant women influences gestational weight gain (GWG) and levels of anxiety or depressed mood. Design and subjects: This study used a longitudinal interventional design. Of the 235 eligible obese pregnant women, 205 (mean age (years): 29±4.5; body mass index (BMI, kg m − 2 ): 34.7±4.6) were randomized to a control group, a brochure group receiving written information on healthy lifestyle and an experimental group receiving an additional four antenatal lifestyle intervention sessions by a midwife trained in motivational lifestyle intervention. Anxiety (State and Trait Anxiety Inventory) and feelings of depression (Edinburgh Depression Scale) were measured during the first, second and third trimesters of pregnancy. Socio-demographical, behavioural, psychological and medical variables were used for controlling and correcting outcome variables. Results: We found a significant reduction of GWG in the brochure (9.5 kg) and lifestyle intervention (10.6 kg) group compared with normal care group (13.5 kg) ( P =0.007). Furthermore, levels of anxiety significantly decreased in the lifestyle intervention group and increased in the normal care group during pregnancy ( P =0.02); no differences were demonstrated in the brochure group. Pre-pregnancy BMI was positively related to levels of anxiety. Obese pregnant women who stopped smoking recently showed a significant higher GWG ( β =3.04; P =0.01); those with concurrent gestational diabetes mellitus (GDM) ( β =3.54; P =0.03) and those who consumed alcohol on a regular base ( β =3.69; P =0.04) showed significant higher levels of state anxiety. No differences in depressed mood or obstetrical/neonatal outcomes were observed between the three groups. Conclusions: A targeted lifestyle intervention programme based on the principles of motivational interviewing reduces GWG and levels of anxiety in obese pregnant women.
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ISSN:	0307-0565 1476-5497
DOI:	10.1038/ijo.2012.162