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World J Obstet Gynecol. May 10, 2014; 3(2): 67-70
Published online May 10, 2014. doi: 10.5317/wjog.v3.i2.67
Cost effective evidence-based interventions to manage obesity in pregnancy
Julie A Quinlivan
Julie A Quinlivan, Institute of Health Research, University of Notre Dame Australia, Fremantle WA 6160, Australia
Julie A Quinlivan, Institute for Women’s and Children’s Research, University of Adelaide, Adelaide SA 5000, Australia
Julie A Quinlivan, Department of Obstetrics and Gynaecology, Joondalup Health Campus, Joondalup WA 6027, Australia
Author contributions: Quinlivan JA designed and wrote the manuscript.
Correspondence to: Julie A Quinlivan, Professor, Institute of Health Research, University of Notre Dame Australia, Suite 106, Private Consulting Rooms, Joondalup Health Campus, Shenton Avenue, Joondalup WA 6027, Australia. quinlivanj@ramsayhealth.com.au
Telephone: +61-8-94009631 Fax: +61-8-94009955
Received: November 23, 2013
Revised: December 28, 2013
Accepted: January 17, 2014
Published online: May 10, 2014
Processing time: 170 Days and 1.4 Hours
Abstract

The rising tide of obesity has seen the prevalence of overweight and obese women presenting for antenatal care approach 50% in recent years. In addition, many pregnant women have gestational weight gain in excess of Institute of Medicine guidelines and develop obesity as a result of pregnancy. Both variables impact adversely upon pregnancy outcome. Individualised programs are not financially viable for cash strapped health systems. This review outlines an evidence-based, public health approach to the management of obesity in pregnancy. The interventions are affordable and in randomised and epidemiological trials, achieve benefits in pregnancy outcome.

Keywords: Obesity; Pregnancy; Randomised trial; Evidence-based

Core tip: Public health approaches are feasible and effective to manage obesity in pregnancy. In primary care settings, women planning pregnancy should have their body mass index monitored in their medical record and receive nutrition advice, have comorbidities of depression and smoking addressed, receive influenza vaccination and education on gestational weight gain targets. Once pregnant, hospital management should focus on monitoring gestational weight gain to Institute of Medicine targets according to the patient’s booking body mass index, combined with screening for diabetes, hypertensive and growth disorders. Following birth, care should handed back to primary care for ongoing weight interventions.