Diet and physical activity interventions to prevent excessive gestational weight gain : a systematic review

Abstract

Background Excessive gestational weight gain (GWG) poses significant risk for maternal and neonatal health. Various guidelines have recommended healthy diets and enhancing physical activity during pregnancy to prevent excessive GWG. However, results of intervention studies are inconsistent in the developed countries, and there are no official guidelines and few interventions for GWG in China. This paper aims to review and synthesize relevant studies on diet and physical activity interventions to prevent excessive GWG so that practical suggestions can be provided to public health authorities in China.

Methods This systematic review was performed using PubMed, Google and Google Scholar to search all relevant studies in English and randomised controlled trials (RCTs) that investigated diet and physical activity interventions to limit excessive GWG up to May 2014. The quality of included studies was assessed using CONSORT statement and JADAD scale.

Results Nine studies describing diet and physical activity interventions to prevent excessive GWG were incorporated in the systematic review. Overall, the contents of interventions were diverse, which consisted of one-to-one counselling, and community-based physical activity interventions. Weekly mailed newsletters and supportive telephone calls were used as assistive tools to remind pregnant women of limiting excessive GWG. Seven studies showed less weight gain in pregnant women receiving the intervention, of which four studies demonstrated a reduction in excessive GWG in women with varying body mass index (BMI) spanning the normal, overweight and obese categories, while three studies reported a reduction of excessive GWG only in normal weight women and obese women need to be paid attention in the future.

Conclusions The effectiveness of diet and physical interventions to limit excessive GWG may not be confirmed because of limited quality or sample size of intervention studies. However, studies have demonstrated reduction of excessive GWG during pregnancy, in addition to persistent healthy behaviours following such interventions during pregnancy. Further meta-analyses of RCTs studies should be done to confirm the effectiveness of such interventions among Chinese women.