Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial

Nagle, Cate; Skouteris, Helen; Hotchin, Anne; Bruce, Lauren; Patterson, Denise; Teale, Glyn
January 2011
BMC Public Health;2011, Vol. 11 Issue 1, p174
Academic Journal
Background: The increased prevalence of obesity in pregnant women in Australia and other developed countries is a significant public health concern. Obese women are at increased risk of serious perinatal complications and guidelines recommend weight gain restriction and additional care. There is limited evidence to support the effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of midwifery care on restricting gestational weight gain in obese women to the recommended range. The secondary aims of the study are to assess the impact of continuity of midwifery care on: women's experience of pregnancy care; women's satisfaction with care and a range of psychological factors. Methods/Design: A two arm randomised controlled trial (RCT) will be conducted with primigravid women recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI=30 who are less than 17 weeks gestation. Women allocated to the intervention arm will be cared for in a midwifery continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women allocated to the control group will receive routine care in addition to the same informational leaflet. Weight gain during pregnancy, standards of care, medical and obstetric information will be extracted from medical records. Data collected at recruitment (self administered survey) and at 36 weeks by postal survey will include sociodemographic information and the use of validated scales to measure secondary outcomes. Discussion: Continuity of midwifery care models are well aligned with current Victorian, Australian and many international government policies on maternity care. Increasingly, midwifery continuity models of care are being introduced in low risk maternity care, and information on their application in high risk populations is required. There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women who are obese and the findings from this project may have application in other maternity services. In addition this study will inform a larger trial that will focus on birth and postnatal outcomes. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12610001078044.


Related Articles

  • Obesity and pregnancy. Stotland, Naomi E. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;1/10/2009, p107 

    The article presents an overview of the physical impact that obesity can have on pregnancy and the impact that obesity can have on pregnancy planning. A discussion of the ways that obese women should be managed by physicians in the different trimesters of pregnancy, and of strategies that can be...

  • Why size matters. Lynch, Elizabeth // Nursing Standard;1/10/2007, Vol. 21 Issue 18, p22 

    Women who are obese have higher risks of complications during pregnancy than their non-obese counterparts, reinforcing the need for health professionals to get healthy eating messages across.

  • go ask your mother. Haar, Kristina // Joe Weider's Muscle & Fitness Hers;Jul2003, Vol. 4 Issue 5, p24 

    Presents a strategy on determining the risk of obesity in a woman.


    The overall trend toward a higher incidence of obesity in the general population naturally results in an increased prevalence of obesity complicating pregnancy. Rates of obesity vary by geographic region, and disparity is also noted among different socioeconomic and racial/ethnic groups. Obesity...

  • Pregnancy outcome of the obese in Ilorin. Adesina, K.; Aderibigbe, S.; Fawole, A.; Ijaiya, M.; Olarinoye, A. // Obstetric Medicine (1753-495X);Dec2011, Vol. 4 Issue 4, p160 

    Background: Obesity is a nutritional disorder that is fast becoming a public health issue in the developing world. It is associated with increased incidence of maternal complications and adverse perinatal outcome. Methods and results: This is a case-control study of obesity in pregnancy carried...

  • Obesity is an Independent Risk Factor After Oocyte Donation.  // Fertility Weekly;6/16/2003, p6 

    Presents a study in Spain on the association of obesity with significant increase in early pregnancy loss. Determination of body mass index; Demonstration of lower implantation rates; Recommendation of weight loss for women trying to get pregnant.

  • Weight Loss in Obese PCOS Patients May Improve Fertility.  // Fertility Weekly;9/15/2003, p5 

    Focuses on the possibility of the achievement of spontaneous pregnancy in obese patients with polycystic ovary syndrome (PCOS) through weight loss. Risks associated with obesity; Administration of a study by researchers Pier Giorgio Crosignani and associates in Italy on the effects of weight...

  • Obesity in pregnancy 'as bad as smoking'.  // GP: General Practitioner;8/6/2010, p14 

    The article reports that a study by Great Britain's National Institute for Health and Clinical Excellence (NICE) has suggested that mums-to-be should consider the risk of being obese in the same way as smoking while pregnant. It said that obese pregnant women are more likely to develop impaired...

  • An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy. de Jersey, Susan J.; Nicholson, Jan M.; Callaway, Leonie K.; Daniels, Lynne A. // BMC Pregnancy & Childbirth;2013, Vol. 13 Issue 1, p1 

    Background: Maternal obesity, excess weight gain and lifestyle behaviours during pregnancy have been associated with future overweight and other adverse health outcomes for mothers and babies. This study compared the nutrition and physical activity behaviours of Australian healthy (BMI ⩽ 25...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics