A randomized controlled trial of daily weighing in pregnancy to control gestational weight gain

Christopher Arthur,Alka Kothari,Emma Ballard,Ellen Di Corleto

doi:10.1186/s12884-020-02884-1

Abstract

BackgroundExcessive gestational weight gain is a modifiable risk factor for the development of obstetric and neonatal complications, and can have a lifelong impact on the health of both mother and offspring. The purpose of this study was to assess whether in addition to standardized medical advice regarding weight gain in pregnancy (including adherence to the Institute of Medicine (IOM) guidelines) (IOM (Institute of Medicine) and NRC (National Research Council, Weight Gain During Pregnancy: Re-examining the guidelines, 2009)), the addition of daily weighing would provide a low cost and simple intervention to reduce excessive weight gain in pregnancy by maintaining weight gain within the target range.MethodsWomen presenting for antenatal care to a secondary level hospital were randomised to routine care or daily weight monitoring. Both groups received nutrition and exercise advice.ResultsThree hundred and ninety-six women were randomised to either the daily weight monitoring group or control group with complete data available for 326 women. The percentage weight gain above target (86.9% (SD 52.3) v 92.7% (SD 50.8) p = 0.31) and change in weight per week during the study period (0.59 kg (SD 0.30) v 0.63 kg (SD 0.31) p = 0.22) were lesser in those undergoing daily weighing compared to routine management, however these did not reach statistical significance.ConclusionDaily weight monitoring as a stand-alone intervention has potential to reduce excessive gestational weight gain. It may have a role as a part of a larger intervention involving dietary and exercise modifications.Trial registrationThe trial was prospectively registered with the Australian New Zealand Clinical Trials Registry. (ACTRN12613001165774, 23/10/ 2013).

Highlights

Excessive gestational weight gain is a modifiable risk factor for the development of obstetric and neonatal complications, and can have a lifelong impact on the health of both mother and offspring
The offspring of mothers who have excessive gestational weight gain (GWG) have an earlier average age of menarche and a greater proportion measure as obese during their pre-schooling, schooling and adult years compared to peers born to mothers who were able to adhere to GWG recommendations [3,4,5]
Excessive GWG is associated with postpartum weight retention and lifetime obesity [6]

Summary

Introduction

Excessive gestational weight gain is a modifiable risk factor for the development of obstetric and neonatal complications, and can have a lifelong impact on the health of both mother and offspring. The short term complications of excessive gestational weight gain (GWG) include fetal macrosomia and increased caesarean delivery rates [1], as well as early childhood obesity [2]. Zealand College of Obstetricians and Gynaecologists guidelines for routine antenatal care and management suggest weighing a pregnant woman only at her booking visit, in order to determine her pre pregnancy body mass index (BMI) and stratify risk [8]. Whilst an increased frequency of weight monitoring in pregnancy has not been proven to improve maternal or fetal outcomes, multiple studies have not been consistent in practice, and have focused on weighing at routine antenatal clinic appointments [10, 11], monthly [2], or at the determination of the woman [12]

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