Title: 2013 GPARTS: dr Madeline Brennan
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Title: ‘Simple Steps’ to a healthier pregnancy; A physical activity intervention in overweight and obese pregnant women to aid weight management during pregnancy. Background: Obesity levels are rising globally and the prevalence of obesity is increasing in pregnant women. Adverse outcomes for both the mother and unborn child in pregnant women who are overweight or obese are well documented. NICE released guidelines in 2010 regarding weight management before, during and after pregnancy which identified recommendations for research in this area. They highlighted a need for research to evaluate the most effective ways of helping women to manage their weight during pregnancy. Also specifically mentioned were those women who are obese, aged less than 18 years old and those from disadvantaged, low income and minority ethnic groups. In 2009 the US Institute of Medicine (IOM) set out guidelines for acceptable levels of Gestational Weight Gain (GWG) in pregnancy; these for overweight women (BMI 25-29.9) are approximately 7-11kg and for obese women (BMI>30), 5-9kg. Aim: To test the feasibility of delivering a physical activity intervention during pregnancy to avoid excess gestational weight gain in overweight and obese women.Pregnant women will be recruited at their booking antenatal visit, either at general practice or hospital, not later than 16 weeks’ gestation. Women with BMI 25-39 will be identified, given face to face information about the trial by their healthcare staff and offered an information leaflet. With their agreement, a consent form will be signed to allow the researcher to contact them by telephone in one weeks’ time to determine if willing to participate in the study. Following baseline assessment, with their consent, participants will be randomised to either control or intervention arm. Aim for 15-20 patients in each. Both groups will receive the same baseline assessment and review measurements: Basic information to include: Booking BMI, age, parity, marital status, ethnicity, occupation, postcode. Baseline Pregnancy Activity Questionnaire. Accelometer data with focus on step count activity and weight recorded at baseline, 6 weeks later and 30 weeks gestation. Basic dietary advice; DINE at baseline. Intervention group: This group will receive, in addition to the above, a physical activity intervention; 1:1 counselling session (behavioural modification), delivered by a trainee general practitioner. This will include information regarding potential harm for mother and baby with respect to overweight and obesity in pregnancy. CMO physical activity guidelines and feasible means of increasing physical activity levels during pregnancy will be discussed and patients will be encouraged to set their own realistic goals. Information given will include IOM recommended Gestational Weight Gain values and the intervention will dispel myths regarding diet and physical activity in pregnancy. The outcome of this study will determine the feasibility of a physical activity intervention to aid weight management during pregnancy. The goal would be to develop a intervention to reduce GWG and improve both maternal and foetal outcomes. This could be tested in a randomised controlled trial and if found effective would thus address the rising public health problem of obesity.


Research activity codes: 6.7 PHYSICAL
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH