WE’RE all familiar with the phrase ‘eating for two’ when it comes to pregnant women - but the reality is that excess weight gain during pregnancy can lead to an increased risk of a range of pregnancy complications like estational diabetes mellitus, pre-eclampsia, Caesarean section, maternal mortality and labour induction.
Maternal obesity is also a risk factor for childhood obesity and obesity in early adult life.
In response, researchers based at the University of Ulster are identifying ways to find solutions to the increasing problem of excess weight gain, and a team from the organisation’s Institute of Nursing Research based at Jordanstown has identified individually tailored ‘goal setting’ strategies as an effective way of helping women avoid gaining too much weight during pregnancy.
A research paper, written by PhD student Mary Jane Brown and supervised by the University’s Professor of Midwifery Research, Marlene Sinclair, has just been published by PLoS ONE, a prestigious, peer-reviewed, open access journal, and is arousing widespread interest from academics and healthcare professionals.
The result of more than a year’s research, the project is one of five currently underway by the university’s Maternal, Fetal and Infant Research Team in partnership with the maternity unit at the Ulster Hospital, Dundonald.
Says Professor Sinclair: “Excess gestational weight gain is a growing problem.
“Putting on too much (or too little) weight during pregnancy can affect the outcome of the pregnancy itself and can have a detrimental effect on both mum and baby, both in the short and long term.
“And difficulty in losing ‘baby weight’ after childbirth is strongly associated with excessive weight gain in pregnancy.
“Mums-to-be used to be weighed regularly and I was very concerned when that stopped because it gave the impression that weight wasn’t an issue during pregnancy.
“It’s important that we develop ways to help pregnant women achieve and maintain optimal weight gain, i.e. the correct amount – not too much and not too little.”
She continues: “Past studies have shown that pregnancy is what’s known as a ‘teachable period’ in a woman’s life – a time when health and nutrition are of utmost importance to her. And the mums-to-be we have been working with on these projects have been really enthusiastic.
“Our research has identified individual ‘goal setting’ as a major motivational tool for helping women avoid excess gestational weight gain.”
Adds Mary Jane: “When women gain too much weight during pregnancy, they struggle to lose it afterwards. And then if they have another baby, before they’ve lost it, they put on even more. The effect can be cumulative.
“What we have been investigating is how to help women manage their weight during pregnancy through different interventions, strategies and routine antenatal care.
“What we specifically looked at was goal setting strategies – realistic goals that midwives and medical professionals can help women achieve and also support and encourage them and provide feedback.
“The most positive results were from interventions that offered a combination of individualised diet and physical activity plans, self-monitoring and performance feedback.”
Professor Sinclair adds: “With regards to goal setting, one size doesn’t fit all. It’s about working in partnership with women and using the range of resources and range of experts available in the health service to offer support.
“Unfortunately, none of this is happening at the moment. We need government policy, education and training for midwives and doctors and we need women to be given the right information tailored to their specific needs.
“We have been working alongside the South Eastern Health and Social Care Trust’s Head of Midwifery and Gynaecology, Dr Elaine Madden in the maternity unit at the Ulster Hospital and the next stage of our work is to design an intervention for optimum weight gain during pregnancy. We hope to run a pilot in 2013.
“I want women to know that in Northern Ireland, there are a group of researchers at the University of Ulster who are working very hard to redesign antenatal education to make it more relevant and help them have a happy healthy pregnancy.”
*The title of the University of Ulster research paper is: ‘A Systematic Review Investigating Healthy Lifestyle Interventions Incorporating Goal Setting Strategies for Preventing Excess Gestational Weight Gain’
To read the research paper in full, click on the link: http://www.plosone.org/article/info.
n The research team for the project were: Mary Jane Brown, University of Ulster; Marlene Sinclair, Professor of Midwifery Research, University of Ulster; Dr Elaine Madden, Head of Midwifery and Gynaecology, South Eastern Health and Social Care Trust, Belfast; Dr Dianne Liddle, Lecturer in Health and Rehabilitation Sciences, University of Ulster; Dr Alyson Hill, Lecturer in Dietetics, University of Ulster and Dr Janine Stockdale, Midwifery Research Theorist and associate member of the Maternal, Fetal and Infant Research Team at the University of Ulster.