Consistent Weight Gain Tracking is Associated with a Reduction in Gestational Weight Gain in High Income Women

Abstract

ObjectiveTo determine the importance of using the weight gain tracker in a multi‐feature integrated mobile phone and online healthy lifestyle intervention designed to prevent excessive gestational weight gain (GWG).MethodsA 3‐arm randomized controlled trial with pregnant women in two early pregnancy body mass index (BMI) groups: normal and overweight plus obese class 1; and two income groups: low (Medicaid‐eligible) and high household incomes was conducted to evaluate the effectiveness of the integrated mobile phone and online intervention. Two arms received intervention during pregnancy. Data were collected through online surveys, a medical record audit, and weight tracking was automatically logged by the project website. Data were analysed using both modified Poisson and linear regression models controlling for sociodemographic and timing of weight measurement covariates. Three gestational weight gain outcomes were examined: prevalence of excessive total GWG; prevalence of excessive weekly GWG from 20 weeks gestation until delivery; and total GWG in kg. Consistent weight gain tracking was defined as at least one weight entry in each 45 day time interval of enrolment in the study.ResultsA racially and ethnically diverse sample of 1,335 18 to 35 year‐old healthy pregnant women was recruited into the trial through community‐based practices and clinics and online enrolment. Among higher income women, 49% of women with normal BMI and 27% of overweight plus obese BMI women were consistent weight gain trackers. Tracking was less common among lower income women: 13% among normal BMI and 11% among overweight plus obese BMI. Among higher income normal BMI women, consistent weight gain tracking was significantly associated with all three outcomes: reduced risk of excessive total GWG (p = 0.03); reduced risk of excessive weekly rate of GWG (p = 0.0009); and 1.73 kg less total GWG (p = 0.0002). Among overweight plus obese higher income women, consistent tracking was associated with near significant reductions in the two measures of excessive GWG (p = 0.07 and 0.09) and a significant reduction of 3 kg in total GWG (p <0.0001). Consistent weight gain tracking was not associated with any of the GWG outcomes in low income women.ConclusionsAmong pregnant women with household incomes above the Medicaid eligibility cut‐off, consistent weight gain tracking is an important feature of online and mobile interventions for reducing excessive GWG.Support or Funding InformationGrant No. HL096760