Normative nutrition intervention reduces gestational weight gain in pregnant women

A low-intensity, high-coverage intervention delivered through the public healthcare system under standard operating conditions is effective in reducing gestational weight gain (GWG) and shows potential for successful scale-up, a Chilean study has shown.

The authors evaluated the effectiveness of a normative nutrition intervention in pregnant women on maternal and offspring outcomes in this cluster-randomized controlled trial of 12 primary healthcare centres (PHCs) in Santiago, Chile.

PHCs were randomized to either nutritional intervention (n=5; intervention group) or routine care (n=7; control group). A total of 4,631 pregnant women (mean age, 26.1 years) were included: 2,565 in the intervention group and 2,066 in the control group.

The intervention consisted of four key actions: training of healthcare professionals on nutritional recommendations, counseling of pregnant women on diet and physical activity recommendations, offering a physical activity programme implemented in the participating PHCs, and adequate referral to dietitians. Controls received routine antenatal care.

Of the women, 45 percent were primipara and 24 percent were obese. No between-group differences were observed in the proportion of women achieving adequate GWG (30.3 percent in the intervention group vs 31.3 percent in the control group; odds ratio [OR], 0.94, 95 percent confidence interval [CI], 0.81–1.09). However, women in the intervention group had lower GWG than those in the control group (11.3 vs 11.9 kg; mean difference, –0.63, 95 percent CI, –1.19 to –0.08).

Women who were obese at the beginning of pregnancy benefitted more from the intervention (mean difference, –1.24 kg, 95 percent CI, –2.18 to –0.30; p<0.05). No between-group differences were seen in maternal glycaemic control or neonatal outcomes.