Does counselling help obese pregnant women manage extra kilos?

Excessive weight gain during pregnancy is a cause of worry for both mother and child. A study was conducted to find if regular counselling appointments help pregnant women shed those extra kilos. The findings appear in the journal BMC Medicine.

Based on results with 2,286 women, a team from the Technical University of Munich (TUM) has now shown that although counselling appointments as part of routine prenatal care, can encourage a healthier lifestyle, it does not reduce weight gain.

If a woman gains excessive weight during pregnancy, it could lead to gestational diabetes, an increased risk of cesarean section or excessive birth weight of the newborn.

The goal of the Bavarian Healthy Living in Pregnancy Study (GeliS) was to make pregnant women aware of the problem and to improve their dietary behaviour and physical activity. More than 70 medical and midwife practices in Bavaria participated in the study.

Women in the study group received three counselling sessions (30-45 minutes each) from week 12 of pregnancy, followed by another consultation several weeks after childbirth as part of their preventive check-ups. They also received additional information material as well as forms that allowed them to independently record and monitor their weight gain and physical activity. The control group only received the information material.

A slight reduction in newborn weight:
Hans Hauner explained the initial findings: "Unfortunately, the counselling concept proved unsuccessful and had no measurable effect on maternal weight gain."

Despite the counselling, over 45 per cent of the participants gained more weight than recommended by the international standard of the Institute of Medicine (IOM) over 14 kilograms on average. Furthermore, the counselling did not lead to a reduction in complications such as gestational diabetes, hypertension or premature labour.

Nevertheless, his research team did find some positive effects: An initial look at the extended data shows that many pregnant women did, in fact, pay close attention to their diet and exercised regularly. In addition, more than 85 per cent of women continued the program to the end and readily took the advice they received to heart.

"Evidently, that was not enough to reduce their weight gain. What we saw, however, was a reduction in the size and weight of the babies of the women who participated in the program. That, too, is a small but important achievement," Hauner said. The study team also recommended that counselling sessions be started before the 12th week of pregnancy.