Lindsay KL conducted a research on Gestational weight gain in obese pregnancy: impact on maternal and

foetal metabolic parameters and birthweight.The aim of this prospective, observational study was to
investigate the impact of gestational weight gain (GWG) among euglycaemic obese pregnant women on
maternal and foetal metabolic parameters and neonatal outcome. Total GWG was recorded for 101 obese,
non-diabetic women with a singleton pregnancy. At 28 weeks of gestation, fasting maternal blood samples
were analysed for glucose, insulin, c-peptide and lipids. Cord bloods were collected at delivery for analysis
of glucose, c-peptide and lipids. GWG (meanSD =10.95.5kg) was greatest among those of younger age
and lower body mass index and 58% of women exceeded the Institute of Medicine GWG recommendations
of 5-9kg for obese pregnancy.Greater understanding of the biological mechanisms involved may help guide
future studies to develop targeted interventions for more effective clinical outcomes. This study identified
that higher GWG among obese pregnant women resulted in foetal hyperinsulinaemia even in the absence of
maternal hyperglycaemia, potentially representing a biological pathway for larger birthweight babies. These
results may highlight the need for more intensive dietary and lifestyle interventions among obese women
who would not normally receive additional counselling beyond standard antenatal care if not diagnosed with
glucose intolerance in pregnancy.

A systematic review was done to assess the effect of weight management interventions that include a diet
component on weight-related outcomes in pregnant and postpartum women by Spencer L1, Rollo M, Hauck
Y, MacDonald-Wicks L, Wood L, Hutchesson M, Giglia R, Smith R and Collin C

Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant
role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with
many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG
and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother,
baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as
pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is
a further long term complication of maternal obesity for offspring, which may persist in to adulthood.
Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a
meta-analysis with over 65,000 women showing that, compared to women who gained weight within
recommendations during pregnancy, women with GWG above Institute of Medicine weight gain
recommendations, retained an additional 3.1 kg and 4.7kg after three and greater than or equal to 15 years
postpartum, respectively. The health risk ass

Optimizing Healthy Gestational Weight Gain in Women at High Risk of Gestational Diabetes:
A Randomized Controlled Trial Cheryce L. Harrison1 , Catherine B. Lombard1 , Boyd J.
Strauss2,3 and Helena J. Teede4 Objective: Optimizing gestational weight gain (GWG) in early
pregnancy is of clinical and public health importance, especially in higher risk pregnancies.
Design and Methods: In a robustly designed, randomized controlled trial, 228 pregnant women
at risk of developing gestational diabetes mellitus (GDM) were allocated to either control
(written health information only) or intervention (four-session lifestyle program). All
women received standard maternal care. Measures were completed at 12-15 and 26-28 weeks
gestation. Measures included anthropometrics (weight and height), physical activity
(pedometer and International Physical Activity Questionnaire), questionnaires (risk
perception), and GDM screening. Results: The mean (SD) age [31.7 (4.5) and 32.4 (4.7) years]
and body mass index [BMI; 30.3 (5.9) and 30.4 (5.6) kg/m2 ] were similar between control
and intervention groups, respectively. By 28 weeks, GWG was significantly different between
control and intervention groups [6.9 (3.3) vs. 6.0 (2.8) kg, P < 0.05]. When stratified
according to baseline BMI, overweight women in the control group gained significantly more
weight compared to overweight women in the intervention group [7.8 (3.4) vs. 6.0 (2.2) kg,
P < 0.05], yet in obese women, GWG was similar in both groups. Physical activity levels
declined by 28 weeks gestation overall (P < 0.01); however, the intervention group retained
a 20% higher step count compared to controls [5,203 (3,368) vs. 4,140 (2,420) steps/day,
P < 0.05]. Overall, GDM prevalence was 22%, with a trend toward less cases in the intervention
group (P 0.1). Conclusions: Results indicate that a low-intensity lifestyle intervention,
integrated with antenatal care, optimizes healthy GWG and attenuates physical activity
decline in early pregnancy. Efficacy in limiting weight gain was greatest in overweight women
and in high-risk ethnically diverse women.