DOES AN ANTENATAL EDUCATIONAL PROGRAM IMPROVE MATERNAL OUTCOMES AMONG OBESE PREGNANT WOMEN IN THE KURDISTAN REGION OF IRAQ

Abstract

Background
 Maternal obesity is associated with health risks for mother and new-born. Obesity during pregnancy has increased dramatically in Iraqi Kurdistan.
 Objectives 
 The aim for this study is to assess the influence of an educational program on the maternal pregnancy outcomes of obese women attending primary health centres in a large city in the Kurdistan region of Iraq.
 Methods
 A quasi –experiment was undertaken. 292 pregnant women who attended one of three health centres for their antenatal care prior to 20 weeks gestation were recruited to the study. 99 women were recruited were of normal weight with a BMI of 20-25Kg/m2, (baseline group), 96 women had a BMI ≥ 30 and were randomised to receive normal care (control group) and 97 obese women were allocated to received normal antenatal care and invited to participate in an antenatal education programme (intervention group). Maternal outcomes measured were gestational weight gain during pregnancy, pregnancy induced hypertension, Gestational Diabetes Mellitus and duration of pregnancy.
 Results
 Obese women were older and were more likely to have had more pregnancies than normal weight women. Regarding maternal outcomes there was no statistically significant difference among the three groups regarding pregnancy induced hypertension, and Gestational age at onset of labour. In relation to gestational diabetes mellitus findings indicated that the prevalence of gestational diabetes mellitus was reduced among those obese women who received the educational programme compared to the control and baseline groups. In addition all obese women (intervention and control groups) had a statistically significant lower weight gain in pregnancy compared to baseline group. 
 Conclusions
 The antenatal education programme made a small difference to maternal outcomes. The prevalence of gestational diabetes was reduced in women who accessed the programme suggesting that gestational diabetescould be decreased by educating women during pregnancy regarding healthy diet and exercise.One factor which may have affected the results of this study was the low attendance rate among women who were randomised to receive the education programme. A higher rate of attendance at education classes may have improved outcomes in others areas.