Academic journal article Childhood Obesity

Effects of a Gestational Weight Gain Restriction Program for Obese Pregnant Women: Children's Weight Development during the First Five Years of Life

Academic journal article Childhood Obesity

Effects of a Gestational Weight Gain Restriction Program for Obese Pregnant Women: Children's Weight Development during the First Five Years of Life

Article excerpt

[Author Affiliation]

Ing-Marie Claesson. 1 Department of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Gunilla Sydsjö. 1 Department of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Elisabeth Olhager. 2 Department of Clinical Sciences, Department of Paediatrics, Lund University, Lund, Sweden.

Carin Oldin. 3 Child Health Services, Public Health and Health Care, Region Jönköping County, Jönköping, Sweden.

Ann Josefsson. 1 Department of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Address correspondence to: Ing-Marie Claesson, RNM, PhD, Department of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, SE - 581 83 Linköping, Sweden, E-mail: Ing-Marie.Claesson@liu.se

Introduction

Obesity (BMI ≥30 kg/m2 ) in pregnancy poses a high risk for complications during pregnancy and childbirth (e.g., gestational diabetes mellitus, caesarean delivery, and macrosomia).1-3 Excessive gestational weight gain (GWG) may further worsen the situation for both the mother and the neonate.4,5 Maternal prepregnancy obesity and excessive GWG have shown a strong positive association with a higher BMI and risk of obesity in the offspring.6-9 Also, childhood obesity may result in adverse outcomes later in life.9-11

In studies carried out in Finland, the effect of an intervention undertaken during pregnancy or in early postpartum on the offspring's weight gain during the first four years of life was examined.12-14 The intervention given during pregnancy was not effective in slowing children's weight gain until 4 years of age, whereas the intervention given postpartum showed a slower increase of standardized z-score of weight-for-length/height (ZWL/H) and standardized z-score of BMI (ZBMI) for children in the intervention group compared with a control group.

We have in previous studies shown that an intervention program designed to restrict the GWG to <7 kg was effective among obese pregnant women.15-17 The women in the intervention group gained less weight during pregnancy and had a lower weight at the follow-up assessments two and six years after childbirth, compared with the women in the control group. The aim of this study was to estimate the effect of a GWG restriction program for obese pregnant women on the children's BMI at 5 years of age and weight-for-length/height (WL/H) development from 2 months of age until 5 years of age.

Methods

The study groups comprise children of obese pregnant women who participated in an intervention study during 2004-2006 at the antenatal care clinic (ANC) in Linköping. A control group of obese pregnant women was recruited from the ANCs in two nearby cities. The original study and the follow-up studies are described elsewhere and summarized briefly below.15-17 The intervention program consisted of individual weekly visits during pregnancy and every six months during the first two years after childbirth, with a specially trained midwife aiming to change behaviors regarding nutrition and physical activity. The participants were also invited to join aqua aerobic classes especially designed for obese women. A total of 155 women (67.4%) completed the intervention program. The control group consisted of 193 pregnant obese women who followed the routine program at the ANCs. All women were recruited and included in the study in early pregnancy, i.e., before gestational week 15.

In Sweden all families are offered preventive health care for their children throughout childhood and youth. The preventive health care program is free of charge and reaches almost 100% of all children. …

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