A randomised trial of a four-step multidisciplinary approach to the antenatal care of @entity28 pregnant XXXX .

@entity1 @entity6677 @entity308 @entity28 @entity148 @entity1017
BACKGROUND:    Obesity is common in pregnancy and results in morbidity to mother and newborn. AIM:     To evaluate whether a four-step multidisciplinary protocol of antenatal care for overweight and @entity28 @entity1 would reduce the incidence of @entity6677 . METHODS:    Pregnant @entity1 were approached at their first antenatal visit, and body mass index (BMI) was calculated to determine whether they were overweight or @entity28 (BMI   >   25). Eligible @entity1 were randomised to standard obstetric antenatal care or four-step multidisciplinary antenatal care. Clinic protocol included (i) continuity of obstetric provider; (ii) weighing on arrival at each visit; (iii) a five brief minute intervention by a food technologist who asked about the @entity1 's eating habits of the previous day, provided information on reading food labels, shopping lists of affordable foods available from local shops and recipes for a healthy pregnancy diet; and (iv) clinical psychology management to assess symptoms of @entity308 and @entity148 , stressful life events and determine whether psychological factors were involved in eating patterns. Labour and delivery data were audited from the medical records to determine the final incidence of @entity6677 . The primary outcomes were @entity6677 and @entity1017 . RESULTS:    The intervention was associated with a significant reduction in the incidence of @entity6677 (6 versus 29%, OR 0.17 95% CI 0.03-0.95, P   =   0.04). It was also associated with reduced @entity1017 in pregnancy (7.0 versus 13.8   kg, P   <   0.0001). Despite this, birthweight of newborns was similar [3.5 (0.1)   kg versus 3.4 (0.1)   kg P   =   0.16]. CONCLUSION:     A four-step management plan adopted with @entity28 @entity1 reduces the incidence of @entity6677 .
