Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial.
OBJECTIVES
To assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).


DESIGN
Randomised controlled trial.


SETTING
Antenatal clinic in England.


PARTICIPANTS
Women between 10+0 and 14+6 weeks gestation, not requiring specialist obstetric care.


INTERVENTIONS
Participants were randomised to usual antenatal care or usual care (UC) plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.


PRIMARY AND SECONDARY OUTCOME MEASURES
Excessive gestational weight gain, depression, anxiety and physical activity.


RESULTS
Six hundred and fifty-six women from four maternity centres were recruited: 329 women were randomised to the intervention group and 327 to UC. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation, the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted OR 0.84, 95% CI: 0.53 to 1.33) in the intervention and UC group, respectively. There were no significant difference between the groups in anxiety or depression scores (anxiety: adjusted mean -0.58, 95% CI:-1.25 to -0.8; depression: adjusted mean -0.60, 95% CI:-1.24 to -0.05). There were no significant differences in physical activity scores between the groups.


CONCLUSIONS
A behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.


TRIAL REGISTRATION NUMBER
ISRCTN67427351.
['Daley|Amanda|A|', 'Jolly|Kate|K|', 'Jebb|Susan A|SA|', 'Roalfe|Andrea|A|', 'Mackilllop|Lucy|L|', 'Lewis|Amanda|A|', 'Clifford|Sue|S|', 'Usman|Muhammad|M|', 'Ohadike|Corah|C|', 'Kenyon|Sara|S|', 'MacArthur|Christine|C|', 'Aveyard|Paul|P|']
D000293:Adolescent D000328:Adult D001521:Behavior Therapy D003153:Community Health Services D003150:Community Health Workers D004739:England D005260:Female D005865:Gestational Age D000078064:Gestational Weight Gain D006801:Humans D008427:Maternal Health Services D008880:Midwifery D009765:Obesity D011247:Pregnancy D011248:Pregnancy Complications D011295:Prenatal Care D055815:Young Adult
weighing weight pregnancy pregnancy, weighing, midwives, weight