Birdsall, K. M., Vyas, S., Khazaezadeh, N., Oteng-Ntim, E. (2009).The International Journal of Clinical Practice, 63(3), 494-507.
Obesity among pregnant women is a growing health issue, with implications for pregnancy outcomes and a significant impact on childhood obesity. This study reviewed the current evidence for interventions to promote weight loss or weight control in women around the time of pregnancy. Although several articles were found describing the adverse effects of obesity in pregnancy, there was a deficiency of appropriately designed interventions for maternal obesity. The authors found no known prepregnancy clinical trials aimed at overweight or obese women who were planning to conceive. They reviewed seven trials that reported interventions to limit weight gain during pregnancy and three trials that focused on targeting postpartum interventions. They suggest that sample sizes should be larger, include only primiparous women, and divide women into groups by weight categories. The intervention design should consider ways to overcome the difficulties in motivating overweight and obese women to lose weight; the general success of an individual, structured program; overcoming the barriers encountered by low income women; covering any costs incurred by the intervention; targeting the type of food eaten rather than the quantity; and involving the whole family in the intervention to promote a behavior change in the home. Differences in ethnicity, gestational diabetes, and for weight changes in women who quit smoking should be examined. They also recommend that future trials include long-term observations to assess the impact of interventions during pregnancy.