Mood and Excess Weight Gain in Adolescent Pregnancy
Condition: Obesity; Adolescent Development; Pregnancy Related; Insulin Sensitivity; Interpersonal Relations; Stress
MeSH terms: Insulin Resistance; Weight Gain
Study type: Interventional

Summary: 
      50-70% of adolescents gain too much weight during pregnancy, and this excess gain
      significantly increases their risk of high postpartum weight retention and long-term obesity.
      In this randomized controlled pilot study, the investigators are evaluating the feasibility
      and acceptability of a relatively brief interpersonal psychotherapy program for reducing
      excess gestational weight gain during adolescent pregnancy. Compared to treatment-as-usual
      prenatal care delivered in an adolescent maternity clinic, the investigators will estimate
      the added benefit of an interpersonal psychotherapy program's effectiveness for reducing
      excess gestational weight gain, improving maternal postpartum insulin sensitivity, and
      decreasing maternal and infant adiposity.
    

Detailed description: 
      Obesity and its negative health consequences such as type 2 diabetes and heart disease are
      major public health concerns. Pregnancy is an ideal opportunity to intervene with young women
      both to reduce their own likelihood of long-term obesity and to potentially lessen their
      offspring's obesity risk. Interventions to reduce excessive weight gain during adolescent
      pregnancy may be particularly important. 50-70% of adolescents gain too much weight during
      pregnancy, and this excess gain significantly increases their risk of high postpartum weight
      retention and long-term obesity. Depression and stress-which are common in adolescent
      pregnancy-also may play a role. Pregnant adolescent females, as well as non-pregnant females,
      who have more frequent feelings of depression or stress are more likely to gain weight too
      rapidly or to gain too much weight as they grow. In the current project, the investigators
      seek to develop a program to prevent excess weight gain that will be feasible to administer
      in the Colorado Adolescent Maternity Program (CAMP) at Children's Hospital Colorado,
      University of Colorado Denver, Anschutz Medical Campus, and, that will be acceptable to
      pregnant teens at-risk for gaining too much weight. After a screening assessment, adolescent
      females (13-19y) will be randomly assigned to participate in either a 6-session interpersonal
      psychotherapy (IPT) program + usual care or to CAMP usual care only. The IPT program will
      involve 6 1-hour meetings with a trained facilitator and focus on improving relationships,
      mood, stress, and eating in response to negative feelings. The investigators will assess
      participants midway through the program, immediately after the program, and again at a
      3-month postpartum follow-up. The investigators will evaluate to what extent adolescent
      females attend the program, complete at-home practice assignments, and show changes in mood,
      stress, relationships, eating, and mindfulness before and after IPT participation compared to
      usual care only. The investigators also will estimate how program participation relates to
      weight gain during pregnancy and 3-month postpartum maternal weight retention, adiposity, and
      insulin sensitivity. The investigators also will study the adiposity of adolescents'
      3-month-old infants.
    

Intervention name(s): Interpersonal Psychotherapy; Treatment-as-usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Six individual 1-hour sessions delivered over the course of pregnancy to address interpersonal problems areas that may lead to emotional eating, physical inactivity, and increased stress during pregnancy, which are drivers of excess weight gain in pregnancy; Routine prenatal care as part of multidisciplinary adolescent pregnancy clinic, including medical (ob/gyn), nutrition, and social work
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Care Provider)
Primary purpose: Prevention