According to a new research, dietary and lifestyle interventions are important for overweight and obese women before their pregnancy.The study was published in the journal The Lancet Diabetes and Endocrinology. The researchers reported the results of a large study of birth outcomes in more than 500 overweight or obese women from three public maternity units in Adelaide, Australia.
The GRoW (Metformin for Gestational Restriction of Weight in pregnant women) trial was designed to reduce risks for pregnant women who are overweight or obese.
The researchers investigated the potential of the use of common diabetes medication metformin during pregnancy to reduce pregnancy weight gain and improve pregnancy outcomes.
“In high-income countries, roughly 50% of women are already overweight or obese when they become pregnant. This places both the mother and her infant at risk of a range of pregnancy and birth outcomes and can also lead to high infant birth weight, which in turn can lead to childhood obesity,” said study researcher Jodie Dodd.
The study enrolled women who were pregnant and overweight or obese. Half of the women were given a medication called metformin, usually used for the treatment of type 2 diabetes. All women were given advice on healthy diet and lifestyle.
The researchers found that taking metformin reduced weekly pregnancy weight gain and women were more likely to gain below current recommendations, but this did not reduce the risk of having a baby with birth weight over 4kg. Nor did it reduce the risk of high blood pressure, gestational diabetes or birth by caesarean.
While Metformin has been used in previous studies of obesity in pregnancy, this study is the first to include women who were overweight, as well as obese and the first to combine the medication with dietary and lifestyle advice.
“We’ve now seen a lot of studies showing that dietary and lifestyle advice for pregnant women who are overweight or obese to improve the health of women and their children has very limited benefit,” said Professor Dodd.Prenatal care may include taking extra folic acid, avoiding drugs and alcohol, regular exercise, blood tests, and regular examinations.The usual symptoms and discomforts of pregnancy do not significantly interfere with activities of daily living or pose a health-threat to the mother or baby. However, pregnancy complications can cause other more severe symptoms, such as those associated with anemia.“This study supports that outcome. We need to consider dietary and lifestyle interventions prior to women becoming pregnant if we are going to break the cycle of inter-generational obesity,” concluded Dodd.The terms preterm and postterm have largely replaced earlier terms of premature and postmature. Preterm and postterm are defined above, whereas premature and postmature have historical meaning and relate more to the infant’s size and state of development rather than to the stage of pregnancy.The chronology of pregnancy is, unless otherwise specified, generally given as gestational age, where the starting point is the woman’s last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. Sometimes, timing may also use the fertilization age which is the age of the embryo.Therefore, during a second pregnancy a woman would be described as gravida 2, para 1 and upon live delivery as gravida 2, para 2. In-progress pregnancies, abortions, miscarriages and/or stillbirths account for parity values being less than the gravida number. In the case of a multiple birth the gravida number and parity value are increased by one only. Women who have never carried a pregnancy achieving more than 20 weeks of gestation age are referred to as nulliparous.
