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Minimizing pregnancy weight gain in women with obesity - a challenge for midwives

Konferensbidrag (offentliggjort, men ej förlagsutgivet)
Författare Marie Berg
Åsa Premberg
Karin Haby
Publicerad i 31st International Confederation for Midwives Triennal Conference, 18-22 June, Toronto, Canada
Publiceringsår 2017
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för vårdvetenskap och hälsa
Språk en
Länkar www.icm2017.com/abstract_summary.ph...
Ämneskategorier Hälsovetenskaper

Sammanfattning

Background: Maternal Obesity is an increasing ill health issue associated with increased risk of complications for mother and child, both in a short perinatal perspective and in a life-long perspective. The risk aggravates with increasing maternal BMI and aggravates with increasing gestational weight gain. Purpose/Objective: To investigate whether a lifestyle intervention project at primary care level, offered by midwives to pregnant women with BMI ≥30 would lower gestational weight gain and lower BMI at 3 months after childbirth. Secondary aims were to study if such intervention had positive impact on maternal and child health, to assess the cost efficacy of the intervention, and to explore participating women´s respectively midwives’ experiences. Method: The project was performed years 2011-2013 in Gothenburg, Sweden as a case control study of pregnant women with BMI ≥30 in early pregnancy (n=1165). A control group (n=700) got usual care. Intervention group (n=465) were offered 1) systematised counselling, motivational sessions with midwife concerning nutrition and physical activity 2) group discussions and completing food diary with dietician, 3) aqua aerobics class with midwife/physiotherapist 4) guidance to suitable and locally available health activities 5) availability of pedometers and walking poles. Key Findings: A pilot study show significant positive effect (±SD) on gestational weight gain in the intervention group (8.6±4.9 kg vs. 12.5±5.1kg), and significant better maternal weight at the postnatal checkup. A greater proportion of the intervention group restricted their gestational weight gain to < 7 kg (36% vs. 16%). Full findings will be presented at conference comprising: main outcome whole group (n=1165), cost effectiveness of intervention, and experiences of participating midwives and women. Discussion: To establish good evidence based routines for pregnant women with obesity is important and especially by midwives. This study will inform us if this relatively low intensive intervention can improve maternal and child health in pregnancy, childbirth and first months postpartum. References: Haby K, Glantz A, Hanås R, Premberg Å. Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity. Midwifery 2015; 31 (7):685- 692. Marchi, J., Berg, M., Dencker, A., Olander, E. K., & Begley, C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes. Rev. 2015;16(8):621-38. doi: 10.1111/obr.12288. Epub 2015 May 28.

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