BACKGROUND AND PURPOSE:

• Research regarding interventions to prevent excess gestational weight gain are needed
  • Benefits of traditional antenatal weight control strategies have been inconsistent
• Horn et al. (American Journal of Preventive Medicine, 2018) assessed whether an antenatal diet and lifestyle smartphone app could prevent excess gestational weight gain

METHODS:

• Randomized clinical trial (RCT)
  • Overweight and obese ethnically diverse pregnant women (IOM guidelines – see ‘Related ObG Topics’ below)
  • MAMA-DASH (minor modifications to the dietitian-led Dietary Approaches to Stop Hypertension)
• Randomization at 16 weeks to either
  • Intervention: Commercially available smartphone application for self-monitoring, text message prompts and email reminders encouraging adherence
  • Control: E-mailed biweekly newsletters and publicly available maternity website links
• Primary outcome
  • Gestational weight gain measured at baseline, 24 weeks, and 35w0d-36w6d
• Secondary outcomes included
  • Weekly rate of gestational weight gain | Newborn anthropometrics | Maternal diet quality | Physical activity | Blood pressure

RESULTS:

• 140 in intervention | 141 in usual care
  • BMI 25 to <40
  • Age range 18–40 years
  • 37% were non-white
• At 35 weeks, the app was superior at limiting weight gain compared to the control arm (p=0.02)
  • Intervention group: 10 kg
  • Control group: 12 kg
• Most participants exceeded guidelines but this occurred significantly less often in the app group (p=0.004)
  • Intervention group: 69%
  • Control group: 85%
• The rate of weight gain was 0.4 in the intervention group vs 0.5 kg/week in the control group
• Cesarean sections were 40% in the intervention group vs 37% in the intervention group (p=0.03)
• No significant differences were noted in birth weight, percentage body fat, or adverse pregnancy outcomes
• Nutrient quality improved without an adverse impact on rate of prematurity

CONCLUSION:

• The authors recommend further research to determine the association with increased cesarean sections
• Technology-enhanced DASH diet did positively impact gestational weight gain
• IOM goals were not met by most participants and preconception obesity prevention strategies are required

Learn More – Primary Sources:

Dietary Approaches to Stop Hypertension Diet and Activity to Limit Gestational Weight: Maternal Offspring Metabolics Family Intervention Trial, a Technology Enhanced Randomized Trial

Related ObG Topics:

Recommended Weight Gain and Obesity Management in Pregnancy

Maternal Overweight, Obesity and Congenital Malformations – How Strong is the Link?