Choose to change maternity weight management pilot.

Abstract

Obesity during pregnancy is associated with increased risk of adverse health outcomes during pregnancy. There is limited research available regarding effective interventions during pregnancy for obese women and this is combined with local inadequate service provision to support obese mothers in Greater Manchester (GM). Choose to Change (CTC) aims to develop, deliver and evaluate a community based weight management programme to limit excessive gestational weight gain. Participants (n=73) referred from January to December 2013 by Community Midwifery Teams (>18years) with a BMI >30 attended a healthy lifestyle intervention (1:1 or group) covering nutrition, physical activity and behaviour change over 12weeks. Baseline measures were weight, Body Mass Index (BMI), Blood Pressure, physical activity, dietary habits and psychological questionnaires measuring anxiety, self-esteem and dis-ordered eating. 28 clients were assigned to intervention (group (n=15), 1:1 (n=13). Mean age 29 (SD=5.78), mean BMI at referral was 38.96 (SD=4.87). Descriptive statistics suggest an average weight gain for clients (excluding drop outs n=12) is 0.94kg (SD=6.65). For those who have completed the programme (n=8) average weight gain was 1.03kg (SD=7.71). Results vary according to intervention type 1:1, 0.04kg (SD=8.82kg), group, 1.52kg (SD=3.17kg). Drop-out rate from referral to assessment was 62%, from assessment to intervention 32% and during intervention 26%. Overall the results of the present pilot study indicate that the CTC healthy lifestyle intervention can limit excessive gestational weight gain. CTC is looking at future directions for development including changing the assessment procedure to improve DORs, further analysis of various mediating factors including BMI and intervention type and exploration of post-measurements to show further improved health outcomes as the programme is rolled out across GM.