Weight Control Program and Gestational Weight Gain in Disadvantaged Women with Overweight or Obesity: A Randomized Clinical Trial.

Alison G Cahill, Debra Haire-Joshu, W Todd Cade, Richard I Stein, Candice L Woolfolk, Kelle Moley, Amit Mathur, Kenneth Schechtman, Samuel Klein
Author Information
  1. Alison G Cahill: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA. ORCID
  2. Debra Haire-Joshu: School of Public Health and Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
  3. W Todd Cade: Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, USA.
  4. Richard I Stein: Center for Human Nutrition, Washington University in St. Louis, St. Louis, Missouri, USA.
  5. Candice L Woolfolk: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.
  6. Kelle Moley: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.
  7. Amit Mathur: Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, USA.
  8. Kenneth Schechtman: Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, USA.
  9. Samuel Klein: Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, USA.

Abstract

OBJECTIVE: This study aimed to evaluate the efficacy of a home-based lifestyle intervention delivered through Parents as Teachers (PAT) to reduce excessive gestational weight gain (GWG).
METHODS: This was a single-blinded randomized controlled trial conducted as part of the LIFE-Moms consortium at a single university-based tertiary care institution from October 2012 to March 2016. There were 267 socioeconomically disadvantaged (SED) African American women with overweight or obesity (BMI 25.0-45.0 kg/m before pregnancy. Participants were randomized to therapy with standard PAT alone (n���=���134) or PAT plus���a lifestyle intervention program embedded within the standard PAT program (PAT+) (n���=���133). Both interventions were delivered in 10 biweekly home visits during pregnancy. The primary outcome was the percentage of women whose GWG exceeded the Institute of Medicine guidelines, and secondary outcomes included both weekly and total GWG.
RESULTS: Compared with the standard PAT group in the intent-to-treat analysis, the PAT���+���group gained less weekly (0.4 kg vs. 0.5 kg/wk; P���=���0.04) and total (8.0 kg vs. 9.6 kg; P���=���0.02) weight during gestation. Fewer participants in the PAT���+���group had excessive total GWG (36.1% vs. 45.9%), but the difference between groups was not statistically significant (P���=���0.11).
CONCLUSIONS: PAT���+���reduced the weekly and total GWG in SED African American women with overweight or obesity at the start of pregnancy.

Associated Data

ClinicalTrials.gov | NCT01768793

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Grants

  1. P30 DK092950/NIDDK NIH HHS
  2. U01 DK094466/NIDDK NIH HHS
  3. P30 DK056341/NIDDK NIH HHS
  4. UL1 RR024992/NCRR NIH HHS
  5. U01 DK094418/NIDDK NIH HHS
  6. U01 HL114377/NHLBI NIH HHS
  7. U01 DK094416/NIDDK NIH HHS
  8. U01 DK094463/NIDDK NIH HHS
  9. U01 HD072834/NICHD NIH HHS
  10. P30 DK020579/NIDDK NIH HHS
  11. UL1 TR002345/NCATS NIH HHS
  12. U01 HL114344/NHLBI NIH HHS

MeSH Term

Adolescent
Adult
Body Mass Index
Female
Humans
Middle Aged
Obesity
Overweight
Pregnancy
Pregnancy Complications
Single-Blind Method
Surrogate Mothers
Vulnerable Populations
Weight Gain
Young Adult

Word Cloud

Created with Highcharts 10.0.0PATGWG0totalwomenpregnancystandardweeklykgvsP���=���0lifestyleinterventiondeliveredexcessiveweightrandomizedSEDAfricanAmericanoverweightobesityprogramPAT���+���groupWeightOBJECTIVE:studyaimedevaluateefficacyhome-basedParentsTeachersreducegestationalgainMETHODS:single-blindedcontrolledtrialconductedpartLIFE-Momsconsortiumsingleuniversity-basedtertiarycareinstitutionOctober2012March2016267socioeconomicallydisadvantagedBMI250-45kg/mParticipantstherapyalonen���=���134plus���aembeddedwithinPAT+n���=���133interventions10biweeklyhomevisitsprimaryoutcomepercentagewhoseexceededInstituteMedicineguidelinessecondaryoutcomesincludedRESULTS:Comparedgroupintent-to-treatanalysisgainedless45kg/wk0489602gestationFewerparticipants361%459%differencegroupsstatisticallysignificant11CONCLUSIONS:PAT���+���reducedstartControlProgramGestationalGainDisadvantagedWomenOverweightObesity:RandomizedClinicalTrial

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