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  • Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial

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Obstetrics and gynaecology
Original research
Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial
  1. Amanda Daley1,
  2. Kate Jolly2,
  3. Susan A Jebb3,
  4. Andrea Roalfe3,
  5. Lucy Mackilllop4,
  6. Amanda Lewis5,
  7. Sue Clifford2,
  8. Muhammad Usman2,
  9. Corah Ohadike6,
  10. Sara Kenyon2,
  11. Christine MacArthur2,
  12. Paul Aveyard3
  1. 1 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
  2. 2 Institute of Applied Health Research,College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  3. 3 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
  4. 4 Nuffield Department of Women’s and Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, UK
  5. 5 Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
  6. 6 Sherwood Forest Hospitals NHS FoundationTrust, Nottinghamshire, UK
  1. Correspondence to Professor Amanda Daley; a.daley{at}lboro.ac.uk

Abstract

Objectives To assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).

Design Randomised controlled trial.

Setting Antenatal clinic in England.

Participants Women between 10+0 and 14+6 weeks gestation, not requiring specialist obstetric care.

Interventions Participants were randomised to usual antenatal care or usual care (UC) plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.

Primary and secondary outcome measures Excessive gestational weight gain, depression, anxiety and physical activity.

Results Six hundred and fifty-six women from four maternity centres were recruited: 329 women were randomised to the intervention group and 327 to UC. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation, the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted OR 0.84, 95% CI: 0.53 to 1.33) in the intervention and UC group, respectively. There were no significant difference between the groups in anxiety or depression scores (anxiety: adjusted mean −0.58, 95% CI:−1.25 to –0.8; depression: adjusted mean −0.60, 95% CI:−1.24 to –0.05). There were no significant differences in physical activity scores between the groups.

Conclusions A behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.

Trial registration number ISRCTN67427351

  • pregnancy
  • weight
  • weighing
  • pregnancy, weighing, midwives, weight

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2019-030174

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    Footnotes

    • Contributors AD conceived the original idea for the study with input from PA, KJ, SAJ, AL, LM, SC, CM and SK. AD wrote the protocol with contribution from the other authors. SC was responsible for overseeing data collection. CO assisted with data collection and provided clinical advice. AR was responsible for overseeing the writing of the statistical analysis plan. MU conducted the analyses. All authors had full access to the data, taken responsibility for the integrity of the data and the accuracy of the data analysis, contributed to the interpretation of the results and reviewed and approved the final manuscript. AD drafted the article and all other authors commented on this draft. AD is the guarantor.

    • Funding The National Institute of Health Research School for Primary Care Research part funded this study. NIHR CLAHRC-Oxford and NIHR CLAHRC-West Midlands also part funded this study. KJ, CM and SK are part funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West Midlands. SAJ and PA are NIHR Senior Investigators and supported by the Oxford NIHR Biomedical Research Centre and NIHR CLAHRC Oxford. AR is supported by NIHR Oxford Biomedical Research Centre. LM works part time for Sensyne Health plc.

    • Disclaimer The views expressed in this publication are not necessarily those of NHS, the NIHR or the Department of Health. The study was externally peer-reviewed for scientific quality. The funders had no involvement in conducting the research.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Ethical approval was obtained from NRES Committee West Midlands—South Birmingham: 14/WM/1134, 02/10/14. All procedures performed in this study were in accordance with the ethical standards of the institutional review board, the American Psychological Association and the 1964 Helsinki Declaration. Written informed consent was obtained for all individual participants included in this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.