High Risk Obese Pregnancy: Nutritional Program on Maternal Health for Controlling Obesity

Abstract

Background: The incidence of maternal obesity (BMI>30kg/m²) at the start of pregnancy has been rising over the last world. Obesity during pregnancy represents an important preventable risk factor for adverse pregnancy outcomes and is associated with negative long-term health outcomes for both mothers and off springs. Aim: The aim of this study was to evaluate the effect of a nutritional program on maternal health for controlling obesity. Design: A quasi-experimental design was used. Setting: The study was conducted in two MCH centers, MCH of north Giza and MCH of El-Moneab. Sampling: Purposive samples of 100 obese pregnant women were included; attended MCH centers for their first visit. Those women were divided randomly into 50 women for study group; those chosen randomly and received the nutritional program; and 50 women for the control group; who did not receive the program, with, inclusion criteria; pregnant, obese (BMI ≥ 30 kg/m²) and in the first trimester of pregnancy. Exclusion criteria included severe complications of pregnancy and sever co–morbidities not enabling the women to follow the program. Tools for data collection three tools were used. 1) An interviewing questionnaire which includes five parts; socio-demographic characteristics, obstetric history and medical history, obese pregnant women's knowledge, obese pregnant women's lifestyle practices, and daily intake of various food groups and types. 2) Physical assessment to record initial and follow –up weight assessment of the pregnant women. 3) Pregnancy outcomes records including maternal and neonatal outcomes. Results: The study showed that, obese pregnant women's knowledge of dietary and healthy practices life style issues is low, as well as their practices towards diet, exercises, and rest. Their dietary practice during pregnancy is inadequate. Conclusion: The study answered the research hypothesis stating that nutritional program will improve the health of maternal obesity and their newborn without complications, the nutrition program was effective in improving their dietary and healthy lifestyle knowledge and practices. This is associated with significant improvement in lowering body weight throughout follow-up visits during pregnancy, in addition, the nutrition program led to better maternal outcomes as lower rates difficult labor with fetal distress. Fetal outcomes are also improved in terms of better Apgar scores and less need for NICU admissions. Recommendations: The developed nutritional program should be made available at similar MCH centers, and the maternal nurses should use it in educating attendant obese pregnant women.