Antenatal interventions for overweight or obese pregnant women: a systematic review of randomised trials

BACKGROUND: Overweight and obesity during pregnancy is an increasing health problem. OBJECTIVE: A systematic review to assess the benefits and harms of antenatal dietary or lifestyle interventions for pregnant women who are overweight or obese. SEARCH STRATEGY: The Cochrane Controlled Trials Register(CENTRAL) was searched (last search January 2010). Reference lists of retrieved studies were searched by hand. No date or language restrictions were used. SELECTION CRITERIA: Randomised controlled trials comparing antenatal dietary and/or lifestyle or other interventions with no treatment for overweight or obese women were considered.Studies were evaluated independently for appropriateness for inclusion and methodological quality. The primary outcome was large-for-gestational-age infants. DATA COLLECTION AND ANALYSIS: Nine randomised controlled trials were included involving 743 women who were overweight or obese during pregnancy. Seven trials compared a dietary intervention with standard antenatal care. MAIN RESULTS: There were no statistically significant differences identified between women who received an antenatal intervention and those who did not for the large-for-gestational-age infant outcome (three studies; 366 women; risk ratio 2.02; 95% CI 0.84,4.86) or mean gestational weight gain four studies; 416 women;weighted mean difference )3.10 kg; 95% CI )8.32, 2.13 (random effects model). There were no statistically significant differences identified for other reported outcomes. AUTHOR'S CONCLUSIONS: The effect of providing an antenatal dietary intervention for overweight or obese pregnant women on maternal and infant health outcomes remains unclear.