Please select the eligibility criteria that correspond to the clinical trial below.
Title: Expecting Success: Personalized Management of Body Weight During Pregnancy
Brief Summary: The purpose of this study is to determine how to help manage weight gain during pregnancy. This study is part of the National Consortium 'LIFE-Moms: Lifestyle interventions in expectant moms'. LIFE-Moms is 7 studies funded to test different lifestyle interventions in overweight and obese pregnant women.


Options:
A: Inclusion Criteria:

* Are pregnant.
* Are between 18 and 40 years old.
* Have a BMI (a number calculated from your height and weight) equal to or above 25kg/m2.
* Establish prenatal care before 12 weeks of your pregnancy.
* Can read, speak and understand English.

Exclusion Criteria:

* Do not plan to deliver your baby at Woman's Hospital, Baton Rouge, LA
* Are pregnant with more than one infant.
* Have habitually smoked during the last 6 months.
* Currently abuse or have abused illegal or prescription drugs in the last 6 months.
* Consume more than 2 alcoholic drinks per week.
* Are unwilling to avoid pregnancy for 12 months following delivery.
* Are unwilling to enroll your baby in the 12 month follow-up testing planned in this study.
* Are planning to move out of the area within the next 2 years or plan to be out of the study area for more than 1 month in the next year.
* Are unwilling to be assigned at random to any of the intervention groups.
* Are planning to terminate your pregnancy.
* Are planning to give your baby up for adoption.
* Are pregnant with a baby who has a known fetal anomaly.
* Have a reason that exercising is unsafe (determined by your physician or study staff).
* Have had or plan to have bariatric surgery within 1 year of your expected delivery.
* Currently have or have a history of the following:
* 3 or more first trimester miscarriages
* High blood pressure
* Type 1 diabetes
* Diagnosis of pregnancy related diabetes during screening
* HIV or AIDS
* Psychotic disorder, major depressive episode, bipolar disorder or eating disorder
* Any other pregnancy, blood, heart, lung, hormone, or digestive problem that your doctor considers unsafe for participation in this study
B: Inclusion Criteria:

* Singleton viable pregnancy. A twin pregnancy reduced to singleton before 14 weeks by project gestational age is acceptable. An ultrasound must be conducted before randomization that shows a fetal heartbeat; there should be no evidence of more than one fetus on the most recent pre-randomization ultrasound.\*
* Gestational age at randomization no earlier than 9 weeks 0 days and no later than 15 weeks 6 days based on an algorithm that compares the last menstrual period (LMP) date and data from the earliest ultrasound.\*
* BMI ≥25 kg/m2 based on first trimester measured weight and on measured height. The earliest weight measurement before randomization, measured specifically for the study will be used. Reported pre-pregnancy weight will not be used to determine eligibility because of the potential for inaccuracy. If the earliest weight measurement is conducted at 140 to 146 weeks or 150 to 156 weeks, 1 lb or 2 lbs will be subtracted from the measured weight respectively, to adjust to a first trimester weight.\*
* Age ≥ 18\*

Exclusion Criteria:

* Diagnosis of diabetes prior to pregnancy (reported physician diagnosed diabetes other than GDM in previous pregnancy or taking insulin or medications to treat diabetes), or an HbA1c ≥ 6.5 % or other test result (elevated fasting glucose ≥126 mg/dL/7.0 mmol/L or 2 h glucose ≥200 mg/dL/11.1 mmol/L when OGTT is completed) suggestive of pre-pregnancy diabetes. All potential participants will have HbA1c performed prior to randomization.\*
* Known fetal anomaly \*
* Planned termination of pregnancy\*
* History of three or more consecutive first trimester miscarriages\*
* Past history of anorexia or bulimia by medical history or patient report. Binge eating disorder is not an exclusion\*
* Current eating disorder diagnosed by EDE-Q questions 2-4 and confirmed after discussion with the participant by study staff\*
* Actively suicidal defined as a value ≥ 2 on the BDI-II question 9\*
* Prior or planned (within 1 year of expected delivery) bariatric surgery\*
* Current use of one or more of the following medications: \*

  * Metformin
  * Systemic steroids
  * Antipsychotic agents
  * Anti-seizure medications or mood stabilizers that would be expected to have a significant impact on body weight
  * Medications for ADHD including amphetamines and methylphenidate
* Continued use of weight loss medication including OTC and dietary supplements for weight loss \*
* Contraindications to aerobic exercise in pregnancy specified in the ACOG Committee Opinion #267, 2002 (reaffirmed 2009) \*

  * Hemodynamically significant heart disease defined as an AHA class II (short of breath with exercise) or greater
  * Restrictive lung disease (e.g. pulmonary fibrosis)
  * Poorly controlled seizure disorder
  * Poorly controlled hypertension (blood pressure ≥160/110)
  * History of extreme sedentary lifestyle (e.g. bed bound)
  * Orthopedic limitations to aerobic exercise
  * Severe anemia defined as a hemoglobin \< 8 g/dl or hematocrit \<24 %
* Participation in another interventional study that influences weight control\*
* Enrollment in this trial in a previous pregnancy\*
* Intention of the participant or of the care provider for the delivery to be outside the LIFE-Moms Consortium hospital\*
* Participant's unwillingness or inability to commit to a 1 year follow-up of herself or her child, including planning to move away\*
* Past or current intravenous drug use (visual check for injection marks, recorded methadone use, self-report)
* Self-reported HIV infection (confirmed from medical records or baseline test results)
* Inability to functionally participate in group sessions and other study requirements on a regular basis during the complete duration of the study, including but not limited to the documented use of the accelerometer for the periods required by the study
* Non Spanish speaking
* Plan on giving up infant for adoption

'\*' Core eligibility criterion for the LIFE-Moms Consortium
C: Inclusion Criteria:

- All children born to obese women who participated in the LiP study (a randomized controlled trial of lifestyle intervention during pregnancy) and children born at term to healthy women with a normal pregestational BMI.

Exclusion Criteria:

- The children born to normal weight women only: preterm birth, congenital anomalies, maternal gestational diabetes, maternal diabetes mellitus, severe medical conditions in either child or mother.
D: Inclusion Criteria:

1. Establish prenatal care at 6 - 16 weeks gestation
2. 18-49 years of age
3. Receive their entire prenatal care at the Resident Obstetrics Clinic
4. English and/or Spanish speaking
5. Singleton gestation.

Exclusion Criteria:

1. Establish prenatal care \>16 weeks gestation
2. Non-English or non-Spanish speaking
3. Multiple gestation pregnancy
4. BMI \> 40
5. Preexisting diabetes, untreated thyroid disease, or hypertension requiring medication or other medical conditions that might affect body weight
6. Delivery at institution other than CMC-Main
7. Pregnancy ending in a premature delivery (\< 37 weeks)
8. Limited prenatal care (\<4 visits)

Answer: A