Abstract
Objectives: The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on excessive gestational weight gain (GWG) in a low-income, predominantly overweight/obese population. Methods: Participants (n = 83) were mostly overweight/obese women recruited at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics on the island of O’ahu, Hawai’i at 15–20 weeks gestational age. The intervention group received SMS on nutrition and physical activity during pregnancy designed to help them meet Institute of Medicine (IOM) guidelines for GWG and American College of Obstetricians and Gynecologists guidelines for exercise, respectively. The control group received SMS about general health topics during pregnancy, excluding nutrition and physical activity. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last self-reported weight taken before delivery and participants’ self-reported weight before pregnancy. Differences between study groups were examined using t-tests and Chi-square tests. Linear regression models were used to examine association of GWG with study group and other factors. Results: GWG was similar (p = 0.58) in the control group (14.1 ± 11.4 kg) and the intervention group (15.5 ± 11.6 kg). The percentage of participants exceeding IOM guidelines for GWG was similar (p = 0.51) in the control group (50.0%, n = 17) and the intervention group (60.5%, n = 23). Conclusions: GWG was not significantly different between intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer intervention durations and varying message frequency as well as personalized or interactive messages may be needed to produce significant improvements.
Highlights
Excessive gestational weight gain (GWG) in overweight or obese women is associated with adverse pregnancy outcomes [1]
By follow-up at the last weight taken before pregnancy, 11 participants had been lost, four from the intervention group (n = 38) and seven from the control group (n = 34)
The average weight before pregnancy was higher in the intervention group than that in the control group, but this difference was not significant
Summary
Excessive gestational weight gain (GWG) in overweight or obese women is associated with adverse pregnancy outcomes [1]. These outcomes include gestational diabetes mellitus, birth complications, postpartum weight retention, and childhood overweight or obesity [1,2]. About 60% of overweight or obese women in the US experience excessive GWG [3]. Healthy eating and physical activity are important modalities for managing GWG [4,5]. The systematic review by Skouteris et al found that interventions focusing on either nutrition or physical activity were less successful in reducing GWG than those that combined the two approaches [6]. Focus groups of Nutrients 2020, 12, 1428; doi:10.3390/nu12051428 www.mdpi.com/journal/nutrients
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