Following a healthy calorie controlled diet during pregnancy
is safe for women who are overweight and obese. Reducing weight can help lower
the risk of serious complications such as pre-eclampsia, diabetes and premature
birth, according to a study published on BMJ.
In the UK,
more than half the women of reproductive age are overweight or obese, and
across Europe and the US,
up to 40% of women gain more than the recommended weight in pregnancy.
Excessive weight gain during pregnancy is associated with a number of serious
Pregnancy is thought to be an ideal time for health
professionals to discuss weight management as mothers are motivated to make
changes that will benefit themselves and their baby.
So a team of researchers, led by Dr Shakila Thangaratinam
from Queen Mary, University
of London, investigated
the effects of diet, exercise, or a combination of the two on weight gain
during pregnancy and any adverse effects on mother or baby.
They analyzed the results of 44 randomized controlled trials
involving over 7,000 women. Study design and quality were taken into account to
Weight management interventions in pregnancy were effective
in reducing weight gain in the mother. Dietary intervention resulted in the
largest average reduction in weight gain (almost 4 kg) compared with just 0.7
kg for exercise and 1 kg for a combination of the two. Diet also offered the
most benefit in preventing pregnancy complications such as pre-eclampsia,
diabetes, high blood pressure and premature birth.
However, the authors stress that the overall evidence rating
was low to very low for these important outcomes.
Importantly, the results showed that interventions are safe
and do not adversely affect the baby's weight. The authors conclude that
dietary and lifestyle interventions in pregnancy improve outcomes for both
mother and baby, but acknowledge the lack of data on risk factors such as age,
ethnicity and socioeconomic status.
However, in an accompanying editorial, experts at St Thomas' Hospital in London say there is not yet sufficient
evidence to support any particular intervention.
Lucilla Poston and Lucy Chappell suggest that although
this study is "timely and welcome", it does not provide the evidence needed for
the National Institute for Health and Clinical Excellence (NICE) to reassess
the guidelines for weight management in pregnancy. They point to several ongoing trials that
will enable a greater understanding of effective interventions in overweight
and obese women.