Abstract

BackgroundExcessive gestational weight gain can result in poor maternal and child health outcomes. Estimates from single studies indicate the prevalence of excessive gestational weight gain in Australia could lie between 38 and 67 %. The risk of excessive weight gain can be reduced through healthy eating and exercise. We describe the rationale and methods of the Get Healthy in Pregnancy Service, a trial service which aims to support women in achieving appropriate gestational weight gain through an existing telephone-based health coaching service.Methods/DesignThis study aims to compare the effectiveness of a telephone-based health coaching program versus provision of information only in supporting pregnant women to achieve appropriate gestational weight gain. A pragmatic stratified clustered randomised controlled trial will be conducted with 710 women who present to 5 hospitals for their first antenatal appointment during the recruitment period (6–8 months), have a pre-pregnancy body mass index (BMI) ≥ 18.50 (healthy weight or above), are 18 years and over, singleton gestation, English speaking, have no pre-existing medical conditions that may limit their ability to exercise or require a restricted diet and are 18 weeks or less gestation. Hospitals will be randomised into one of two intervention models: a) information only; or b) information plus 10 telephone-based health coaching sessions with a university qualified coach. Both interventions will set a weight-range target with pregnant women. The women attending antenatal clinics at participating hospitals will be screened at their initial hospital appointment to assess their eligibility. Women recruited to the trial will have a number of measures recorded including anthropometrics (self-reported height and weight) and dietary and physical activity scores during and following pregnancy. These measurements will be collected at baseline (prior to 18 weeks gestation), 36 weeks gestation and 12 months post-birth.DiscussionThis study responds to a need for an effective intervention that targets excessive gestational weight gain at a population level. This study investigates the potential for an innovative intervention combining two existing services; a free state-wide telephone-based health coaching service and hospital-based antenatal care to support pregnant women to achieve healthy weight gain during pregnancy. The use of existing services provides the potential for immediate post-study implementation. While the impacts of telephone-based lifestyle programmes have been tested in a number of settings, there are few studies which evaluate the effectiveness and acceptability of telephone support in achieving healthy gestational weight gain in association with routine antenatal care.Trial registrationACTRN12615000397516 (Registration date: 26 June 2014, retrospectively registered).Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1704-z) contains supplementary material, which is available to authorized users.

Highlights

  • Excessive gestational weight gain can result in poor maternal and child health outcomes

  • This study responds to a need for an effective intervention that targets excessive gestational weight gain at a population level

  • This study investigates the potential for an innovative intervention combining two existing services; a free state-wide telephone-based health coaching service and hospital-based antenatal care to support pregnant women to achieve healthy weight gain during pregnancy

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Summary

Introduction

Excessive gestational weight gain can result in poor maternal and child health outcomes. Excessive gestational weight gain (EGWG) is associated with poor maternal and infant health outcomes, including an increased risk for gestational hypertension, gestational diabetes, caesarean section, low apgar scores and infants who are born large for gestational age [1,2,3,4]. The guidelines provide ranges of recommended weight gain for specific pre-pregnancy BMI categories, based on the least risk of adverse perinatal outcomes [11]. The first national guidelines for antenatal care in Australia were published in August 2013, recommending that clinicians give women advice about appropriate weight gain during pregnancy in relation to their pre-pregnancy BMI [15]

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