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The healthy eating and lifestyle in pregnancy (HELP) feasibility study

02 October 2014
18 min read
Volume 22 · Issue 10

Abstract

Obesity and excess gestational weight gain (GWG) are linked to increased complications during pregnancy, birth and postpartum.

This study aimed to explore the feasibility of group-based weight management for obese pregnant women. At booking, pregnant women with a body mass index (BMI) >30 kg/m2 were invited to weekly weight management groups, facilitated by a midwife and Slimming World consultant, providing diet and lifestyle, goal setting and general pregnancy advice. Attendance was until 6 weeks postpartum. 148 women with a mean age of 32 years (5.3 SD) and BMI of 37.4 kg/m2 (5.5 SD) attended. 85% (n=126) went to >3 and 65% (n=96) >6 sessions. The mean birth weight for 132 newborns was 3.53 kg (0.49 SD) and for the 39 women losing weight, 3.59 kg (0.35 SD). Of the 132 births, 48% were spontaneous vaginal delivery; 89% (115) initiated breastfeeding; 70% were still breastfeeding 28 days post-delivery.

The healthy eating and lifestyle in pregnancy (HELP) group proved to be an acceptable intervention providing women with the ability to control weight gain during pregnancy, as well as maintaining a healthy lifestyle postpartum. Although the study was underpowered and exploratory, restricting GWG did not have a negative impact on the birth weights or other birth outcomes. Indeed, more babies were born in the healthy weight range to those women who lost weight during pregnancy.

The prevalence of obesity in pregnancy is increasing: around 1 in 5 women attending antenatal care in the UK are obese and in the current obesogenic environment, with a rise in the number of obese teenagers reaching child-bearing age, this figure is likely to fluctuate (Kanagalingam et al, 2005; Shah et al, 2006; Heslehurst et al, 2010). Pregnancy is also a significant causative factor in the development of obesity; women with high weight gain during pregnancy tend to retain more weight at 15 year follow-up (Linné et al, 2004). Thus women who have had a high gestational weight gain (GWG) are more likely to commence their next pregnancy with a higher starting body mass index (BMI).

Obesity and excess GWG have both been linked to an increased risk of complications during pregnancy and birth (Cedergren, 2004; Heslehurst et al, 2008). Complications include: gestational diabetes mellitus, pregnancy-induced hypertension, venous thromboembolism, postpartum haemorrhage and caesarean section (Sebire et al, 2001; Usha Kiran et al, 2005; Bhattacharya et al, 2007). Obesity is also known to increase the risks of shoulder dystocia, birth defects, fetal and neonatal death and stillbirth (Robinson et al, 2003; Chu et al, 2007; Rasmussen and Yaktine, 2009; Stothard et al, 2009). Some of the birth risks are directly related to the increase in large for gestational age (LGA) infant. Antenatal care costs may be 5–16 fold higher in overweight and obese women (Heslehurst et al, 2007).

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