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Preventing excessive weight gain during pregnancy – a controlled trial in primary health care

Abstract

Objective:

To investigate whether individual counselling on diet and physical activity during pregnancy can have positive effects on diet and leisure time physical activity (LTPA) and prevent excessive gestational weight gain.

Design:

A controlled trial.

Setting:

Six maternity clinics in primary health care in Finland. The clinics were selected into three intervention and three control clinics.

Subjects:

Of the 132 pregnant primiparas, recruited by 15 public health nurses (PHN), 105 completed the study.

Interventions:

The intervention included individual counselling on diet and LTPA during five routine visits to a PHN until 37 weeks’ gestation; the controls received the standard maternity care.

Results:

The counselling did not affect the proportion of primiparas exceeding the weight gain recommendations or total LTPA when adjusted for confounders. The adjusted proportion of high-fibre bread of the total weekly amount of bread decreased more in the control group than in the intervention group (difference 11.8%-units, 95% confidence interval (CI) 0.6–23.1, P=0.04). The adjusted intake of vegetables, fruit and berries increased by 0.8 portions/day (95% CI 0.3–1.4, P=0.004) and dietary fibre by 3.6 g/day (95% CI 1.0–6.1, P=0.007) more in the intervention group than in the control group. There were no high birth weight babies (4000 g) in the intervention group, but eight (15%) of them in the control group (P=0.006).

Conclusions:

The counselling helped pregnant women to maintain the proportion of high-fibre bread and to increase vegetable, fruit and fibre intakes, but was unable to prevent excessive gestational weight gain.

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Acknowledgements

We thank the PHNs in the MCs for their valuable work throughout the study. We are also grateful to Katriina Ojala for planning the group exercise sessions. This study was supported by Doctoral Programs in Public Health (DPPH), Finland, and by grants from the National Institutes of Health in the US (1 U54 CA00100971, 5 RO1 CA89950 to Riitta Luoto and Leena Hilakivi-Clarke) and the Ministry of Education and the Ministry of Social Affairs and Health in Finland.

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Correspondence to T I Kinnunen.

Additional information

Contributors: TIK: study design, intervention protocols (especially dietary counselling), acquisition of data, analysis and interpretation of data and preparation of paper. MP: study design, intervention protocols, statistical methodology, analysis and interpretation of data and preparation of paper. MA: study design, intervention protocols (especially physical activity counselling), acquisition of data interpretation of data and preparation of paper. MF: study design, intervention protocols, interpretation of data and preparation of paper. LH-C: obtained funding, study design, interpretation of data and preparation of paper. EW: study design, interpretation of data and preparation of paper. RL: principal investigator, obtained funding, study concept and design, intervention protocols, interpretation of data and preparation of paper.

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Kinnunen, T., Pasanen, M., Aittasalo, M. et al. Preventing excessive weight gain during pregnancy – a controlled trial in primary health care. Eur J Clin Nutr 61, 884–891 (2007). https://doi.org/10.1038/sj.ejcn.1602602

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602602

Keywords

  • pregnancy
  • weight gain
  • intervention
  • diet
  • physical activity

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