Mighty Mums; can a lifestyle intervention for pregnant women with obesity have positive effects on weight gain during pregnancy?

Problem

Maternal obesity is an increasing public health issue and 13% of women in antenatal care (AC) in Sweden have obesity (BMI≥30). The risk of complications during pregnancy and delivery, and for the child, increases with increasing BMI and is aggravated if the gestational weight gain (GWG) is high. From a public health perspective, the burden of obesity for the woman and her family is a challenge considering the complexity of factors associated with lifestyle choices and the impact on health care resources.

Approach

A controlled low intensive lifestyle project, Mighty Mums (MM), was performed in a primary care setting in Gothenborg, Sweden, directed to pregnant women with BMI ≥30. All study participants (n=1165) received standard AC, and the intervention group (n= 465) additionally received support for changing to a more healthy life style. A log was used to register weight, activity and food. The primary aim was to evaluate whether a systematised counselling with the midwife, support from dietician, active guidance to local health centers and availability of pedometers and walking poles, can result in lower mean GWG and lower weight and BMI at the postnatal check-up.

Findings

A previously presented analysis of a pilot group of 50+50 women showed significant effect on GWG (8.6±4.9 kg vs. 12.5±5.1kg; p=0.001) in the intervention group, among whom a greater proportion managed to restrict their GWG to less than 7 kg (36% vs. 16%; p=0.039). The result from the full scale study will be presented and discussed at the conference.

Consequences

Our pilot study showed that with a modest and economically realistic effort - done with simple measures possible to adhere to also after the pregnancy - it is possible to guide the woman in AC towards lifestyle changes that decreases GWG. A project like MM would be of great advantage if incorporated in the regular AC, not only for the health of mothers and babies. This requires a general consensus in the health care organisation that obesity and overweight are important issues, and that the management of AC is supportive and implements an effective method of taking care of the women with overweight and obesity in routine AC.