Gestational weight gain: results from the Delta Healthy Sprouts comparative impact trial

Authors: Thomson, Jessica; TUSSING-HUMPHREYS, LISA - University Of Illinois; Goodman, Melissa; OLENDER, SARAH - University Of Illinois

Submitted to: Journal of Pregnancy
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/12/2016
Publication Date: 8/10/2016
Publication URL: http://handle.nal.usda.gov/10113/5425115
Citation: Thomson, J.L., Tussing-Humphreys, L.M., Goodman, M.H., Olender, S. 2016. Gestational weight gain: results from the Delta Healthy Sprouts comparative impact trial. Journal of Pregnancy. doi.org/10.1155/2016/5703607.

Interpretive Summary: Many women in the United States do not gain the recommended amount of weight during pregnancy. Inappropriate gestational weight gain puts women and their infants at risk for adverse pregnancy, delivery, and birth complications. The Delta Healthy Sprouts Project was designed to test the comparative impact of two maternal, infant, and early childhood home visiting programs on weight status, dietary intake, and health behaviors of women and their infants residing in the rural Lower Mississippi Delta region. This paper reports results from the gestational period in terms of the primary outcome – gestational weight gain. Participants were enrolled early in their second trimester of pregnancy and randomly assigned to one of two arms – Parents as Teachers control treatment (n=43) or Parents as Teachers Enhanced experimental treatment (n=39). Participants’ weight was measured at six monthly home visits in the gestational period. Gestational weight gain was calculated by subtracting the measured weight at each visit from the self-reported pre-pregnancy weight collected at the baseline (enrollment) visit. Weight gain was classified as under, within, or exceeding the Institute of Medicine gestational weight gain recommendations based on pre-pregnancy body mass index. Chi square tests of association and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges. Gestational period retention rates for the control and experimental arms were 77% (33/43) and 67% (26/39), respectively. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits. Additionally, differences in percentages of participants within the guidelines for rate of gestational weight gain were not significant between the control and experimental arms (15% vs. 13%, respectively). Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of Southern, primarily low income, African American women. However, the impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women. Two of the greatest challenges are intervening early in pregnancy and ensuring sufficient dose in the gestational period.

Technical Abstract: Introduction. Delta Healthy Sprouts was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of Southern African American women and their infants. Results pertaining to the primary outcome, gestational weight gain, are reported. Methods. Participants (n=82), enrolled early in their second trimester of pregnancy, were randomly assigned to one of two treatment arms. Gestational weight gain, measured at six monthly home visits, was calculated by subtracting measured weight at each visit from self-reported pre-pregnancy weight. Weight gain was classified as under, within, or exceeding the Institute of Medicine recommendations based on pre-pregnancy body mass index. Chi square tests and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges. Results. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits. Conclusions. Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of primarily low income African American women. The impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women.