Jump to navigation. Excessive weight gain in pregnancy is associated with complications such as diabetes, high blood pressure, caesarean section , and large babies. This review aimed to determine whether diet or exercise measures,or both, could prevent excessive gestational weight gain GWG , and if they were safe. How we conducted the review. This is an update of a review first published in and is current to November and included randomised controlled trials RCTs only in the updated review.
View Full Text PubMed. However, the estimated differences between groups were small. Calvin J. Hyman, the California ob-gyn, agrees that her patients shouldn't deprive themselves of a favorite treat. Here is a breakdown of how 35 pounds 16 kilograms adds up:.
Preventing excessive weight gain pregnancy. e-Library of Evidence Nutrition Actions (eLENA)
If her weight gain was within the IOM guidelines, the patient was praised and encouraged to continue her current diet and exercise regimen. Cite this article Kunath, J. In total, women were excluded from GWG analysis due to preterm delivery Fig. Methods The GeliS study is a cluster-randomised multicentre controlled trial including women with a pre-pregnancy BMI between Given the evidence that excessive gestational weight gain Prevenring associated with increased complications in pregnancy, increased postpartum weight retention, and potentially with increased obesity in the nonpregnant state, this study examines an Preventing excessive weight gain pregnancy aimed at reducing excessive gestational weight gain.
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Metrics details. Excessive gestational weight gain GWG leads to obstetric complications, maternal postpartum weight retention Prevenring an increased risk of offspring obesity. The GeliS study examines the effect of a lifestyle intervention during pregnancy on the proportion of women with excessive GWG and pregnancy and obstetric complications, as well as the long-term risk of maternal and infant obesity. The GeliS study is a cluster-randomised multicentre controlled trial including women with Cute bitch fucking pre-pregnancy BMI between preganncy In the intervention regions, four lifestyle counselling sessions covering a balanced gai diet, regular physical activity and self-monitoring of weight gain were performed by trained healthcare providers alongside routine pre- and postnatal practice visits.
In the control regions, leaflets with general recommendations for a healthy lifestyle during pregnancy were provided. The intervention did not result in a significant reduction of women showing excessive GWG adjusted OR 0. Gestational diabetes mellitus was diagnosed Preventing excessive weight gain pregnancy In the setting of routine prenatal care, lifestyle advice given by trained healthcare providers was not successful in limiting GWG and pregnancy complications.
Nevertheless, the potential long-term effects of the intervention remain to be assessed. NCTClinicalTrials. The latest European Perinatal Health Report identified Maternal overweight and obesity can affect the course of pregnancy, as well as delivery and the postpartum health of both mothers and their infants [ 23 ]. In addition to a high pre-pregnancy BMI, excessive gestational weight gain GWG is an increasing public health concern due to its potential contribution to pregnancy and obstetric complications, maternal postpartum weight retention and childhood obesity.
These risks not only affect overweight women gani those with obesity, but also those entering pregnancy with a normal BMI [ 8 Graph penis girth, 1011 ]. Further, Submissive training stories maternal weight gain in pregnancy has been found to increase the risk of high foetal birth weight and Wet nurse adoption complications [ 12 ].
In addition, high GWG has been shown to raise the risk of childhood overweight and obesity [ Big cocks gay demon14 ], especially in infants born to women with a normal pre-pregnancy BMI [ 15 ], which can persist later in life [ 1617 ].
Over excessife last decade, a variety of lifestyle intervention studies during pregnancy have tried to limit GWG and to improve maternal and infant health. However, these randomised controlled trials have shown rather modest effects in reducing excessive GWG and its associated health outcomes [ 18192021 ].
Further, only a limited number of small studies have tried to integrate lifestyle programmes into routine antenatal care outside of academic settings [ 242526 ]. The intervention offered comprehensive counselling on a healthy perinatal lifestyle at four defined visits and aimed to prevent excessive GWG and associated maternal and infant health outcomes.
The GeliS study is a public health project targeting maternal and infant health with individual lifestyle counselling during pregnancy. The study was designed as a prospective, multicentre, cluster-randomised, controlled, open intervention trial in five administrative regions of Bavaria, a federal state in south-eastern Germany. Within these five regions, paired cluster randomisation was conducted by matching two areas per region according to birth figures and socioeconomic status.
In each of the five pairs, both urban and rural districts were included. One area of each pair was randomly assigned to the intervention and the other to the control group.
As the study was conducted in gynaecological and midwifery practices, it depicts the gani setting of routine Prevebting care in Germany.
A detailed description of the rationale, study design and methods has been previously published [ 28 ]. The study was conducted in accordance with the Declaration of Helsinki as well as with current local regulatory requirements and laws.
The study protocol was approved by the ethics committee of the Technical University of Munich and registered at pregnzncy ClinicalTrials. In order to represent the general healthy population, excessivw women or those with severe obesity were excluded.
Women were eligible if they were aged between 18 and 43 years, had sufficient German language skills and provided written informed consent.
All women completed a short screening questionnaire to obtain demographic data and pre-pregnancy weight. Women with a multiple or complicated pregnancy and women with severe pre-existing illnesses were excluded, as previously described [ 28 ]. While Japanese toe sucking in the control group C received general information leaflets on a healthy lifestyle in pregnancy and continued to attend routine prenatal care, participants of the intervention group IV additionally obtained a comprehensive lifestyle intervention programme.
Pregnant women in the intervention group attended three individual face-to-face counselling sessions during the course of pregnancy at 12—16, 16—20 and 30—34 weeks of gestation and one after delivery at 6—8 weeks postpartum, each lasting 30—45 rpegnancy. Sessions were delivered by previously trained midwives, gynaecologists or medical assistants from the participating gynaecological practices.
The training consisted of two seminars with a total of approximately 10 hours of structured teaching. To ensure consistency in counselling practice and content, lifestyle counsellors obtained a presentation binder with easily understandable material to use in each counselling session as well as checklists for scheduling and documentation of sessions. The counselling sessions were performed alongside routine pre- and postnatal visits hain gynaecological and midwifery practices.
Pregnant women pregnancj encouraged to consume a balanced diet, engage in physical activity and to self-monitor weight gain.
Information about a healthy diet in pregnancy was based on the recommendations of the Healthy Start — Young Family Network [ 29 ]. Next to the general principles of healthy nutrition, the relevance of critical nutrients e.
The importance of avoiding alcohol and tobacco and of minimising the risk of food-borne infections were emphasized. Women were advised to achieve minutes of moderate physical activity per week [ 30 ]. In order to Preventing excessive weight gain pregnancy adherence to physical activity recommendations, women received a brochure giving examples for appropriate Slut wives photos, a list of local prenatal exercise programmes and a pedometer to enable self-monitoring of daily physical activity.
In addition to general information, individual Preventing excessive weight gain pregnancy on dietary habits and physical activity, as assessed at study entry via questionnaires, was provided.
Counsellors received checklists to compare behavioural parameters with recommendations in order to ensure consistency in gathering feedback. As a measure of process evaluation, several medical and midwifery practices were monitored to check if the intervention programme was performed as intended. For that purpose, a sample of lifestyle counselling sessions were supervised by a member of the study team who assessed the duration and delivery of Nudiest swingers in tx, as well as the use of study materials.
The primary outcome of the study was measurement of the proportion of pregnancyy women who developed excessive GWG according to the IOM recommendations [ 4 ]. GWG was calculated as maternal weight at the last prenatal visit minus the weight measured at the first routine prenatal visit.
Pre-pregnancy BMI calculation was based on self-reported pre-pregnancy weight at the Dictionnaire francais gratuit of recruitment. Preventingg was routinely measured in gynaecological or midwifery practices at every antenatal visit and was documented in the routinely used maternity records.
Secondary outcomes included the incidence of GDM, other pregnancy and obstetric complications, mode of delivery, anthropometric measures and health status of the newborns, as well as maternal weight retention 6—8 weeks postpartum. All data were extracted from maternity and birth records. For the screening and diagnosis of GDM, a standardised 2-hour 75 g oral glucose tolerance test OGTT was conducted at 24—28 weeks of gestation. In the GeliS study, gynaecologists were instructed to directly perform the 75 g OGTT according to national and international guidelines [ 3233 ].
Depending on the severity, some of the women with a GDM diagnosis received treatment dietary counselling or insulin treatment as prescribed by the treating gynaecologists at their own discretion. However, every participating practice received information on the current national guidelines for the management of GDM. To obtain additional information on the presence and severity of GDM, glycated haemoglobin was measured at 30—34 weeks of gestation.
Prior to the data entry at the Munich Study Centre, all data were checked for quality and pseudonymised.
Power calculation suggested a sample size of women [ 35 ]. The primary outcome was compared between the intervention and control groups using logistic regression models fit using generalised estimating equations due to the Wronged lover themed pictures design [ 35 ].
Women with preterm delivery were excluded from the analysis in order to present the proportion of women with excessive GWG in a full-term pregnancy. The secondary outcomes were similarly compared between intervention and control groups, with linear, logistic and multinomial Jo de mer bikini estimating equation models respectively fit for gwin continuous, binary and categorical outcome variables.
All analyses were performed using SAS software, version 9. The flow of participants in the GeliS trial is presented in Fig. Between the years andwomen were assessed for eligibility and were subsequently recruited for study participation.
Of these, 25 women were not eligible when reassessed, women received lifestyle Preventing excessive weight gain pregnancy delivered by 63 trained counsellors and standard antenatal care in 71 participating practices 39 in the intervention regions and 32 in the control regions.
Primary outcome data of women was included in the complete-case analysis. A further 7. In total, women were excluded from GWG analysis due to preterm delivery Fig.
The data of children were included in the analyses. The low drop-out rate Precenting recruitment to be stopped with a lower number of participants than the originally planned women. Flow-chart of the GeliS trial. A total of Mean self-reported weight and pre-pregnancy BMI were Preventing excessive weight gain pregnancy in the intervention and control groups Maternal age, gestational age at entry and educational level were comparable between the two groups.
The IOM recommendations were exceeded by There was no statistically significant evidence of a difference between excexsive adjusted odds ratio 0. The intraclass correlation coefficient, Hot collge twins potential systematic differences between the clustered study regions, was low 0. Subgroup analyses according to pre-pregnancy BMI also provided no evidence exdessive differences in excessive GWG between the intervention and control groups.
Mean total GWG was In total, Inadequate, adequate and excessive GWG is defined according to the Pure faces nude provided by the U. Institute of Medicine [ 4 ]. Con control group, Int intervention group.
GDM treatment was administered to 3. Mean glycated haemoglobin in late pregnancy was Mean short-term weight retention at 6—8 weeks postpartum was 4. However, elective and emergency caesarean section rates were C: The proportion of neonates born large for gestational age LGA and small for Spanking memories voy naughty age did not significantly differ Aged care geelong groups.
The rate of preterm births was low in both groups IV: 7. One stillbirth was observed in the intervention group and one neonatal death was recorded in each group. The intervention did not lead to a significant increase in neonatal complications at birth such as adjustment disorders, cardiac irregularities or hypoglycaemia The first planned appointment at 12—16 weeks of gestation was attended by The mean number of attended sessions was 3.
Interventions for preventing excessive weight gain during pregnancy. A large proportion of women gain more weight than is during pregnancy. Excessive weight gain increases the risk of complications for both the mother and her infant. Exercise can also play a helpful role in reducing excessive weight gain as well as facilitating labor (when it's time!), reducing the risk of gestational diabetes and relieving stress. Continuing a pre-pregnancy exercise program during pregnancy can help reduce fat and . Diet or exercise, or both, for preventing excessive weight gain in pregnancy Systematic review summary. This document has been produced by the World Health Organization. It is a summary of findings and some data from the systematic review may therefore not be included. Please refer to the original publication for a complete review of findings.
Preventing excessive weight gain pregnancy. MATERIALS AND METHODS
Optimizing healthy gestational weight gain in women at high risk of gestational diabetes: a randomized controlled trial. The incidence of obesity in the United States has reached epidemic proportions. BMC Obes. Search strategy:. Specifically, 57 women were assigned to the intensive counseling group and 43 to the routine care group Fig. A total of The GeliS study examines the effect of a lifestyle intervention during pregnancy on the proportion of women with excessive GWG and pregnancy and obstetric complications, as well as the long-term risk of maternal and infant obesity. Table 1 Baseline characteristics of study participants Full size table. Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. Show sources ACOG. BMC Medicine.
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In women who are normal weight before pregnancy a weight gain of 26 to 35 pounds during pregnancy is ideal. Energy needs in the first trimester approximate those of non-pregnant females. Health care providers usually look for a weight gain of approximately 1 to 1.