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Objective:Lifestyle intervention could help obese pregnant women to limit their weight gain during pregnancy and improve their psychological comfort, but has not yet been evaluated in randomized controlled trials. We evaluated whether a targeted antenatal lifestyle intervention programme for obese pregnant women influences gestational weight gain (GWG) and levels of anxiety or depressed mood.Design and subjects:This study used a longitudinal interventional design. Of the 235 eligible obese pregnant women, 205 (mean age (years): 29±4.5; body mass index (BMI, kg m−2): 34.7±4.6) were randomized to a control group, a brochure group receiving written information on healthy lifestyle and an experimental group receiving an additional four antenatal lifestyle intervention sessions by a midwife trained in motivational lifestyle intervention. Anxiety (State and Trait Anxiety Inventory) and feelings of depression (Edinburgh Depression Scale) were measured during the first, second and third trimesters of pregnancy. Socio-demographical, behavioural, psychological and medical variables were used for controlling and correcting outcome variables.Results:We found a significant reduction of GWG in the brochure (9.5 kg) and lifestyle intervention (10.6 kg) group compared with normal care group (13.5 kg) (P=0.007). Furthermore, levels of anxiety significantly decreased in the lifestyle intervention group and increased in the normal care group during pregnancy (P=0.02); no differences were demonstrated in the brochure group. Pre-pregnancy BMI was positively related to levels of anxiety. Obese pregnant women who stopped smoking recently showed a significant higher GWG (β=3.04; P=0.01); those with concurrent gestational diabetes mellitus (GDM) (β=3.54; P=0.03) and those who consumed alcohol on a regular base (β=3.69; P=0.04) showed significant higher levels of state anxiety. No differences in depressed mood or obstetrical/neonatal outcomes were observed between the three groups.Conclusions:A targeted lifestyle intervention programme based on the principles of motivational interviewing reduces GWG and levels of anxiety in obese pregnant women. [ABSTRACT FROM AUTHOR]

Background: To ensure a good pregnancy outcome after bariatric surgery, a healthy life-style and a multidisciplinary prenatal follow-up is recommended. The aim of this prospective multicenter trial was to compare diet quality and physical activity (PA) of pregnant women with bariatric surgery with current lifestyle recommendations. Methods: Pregnant women (>18 years, prepregnancy BMI 28 ± 6 kg/m², 39 % nulliparae, 25 % smokers) with a history of bariatric surgery were recruited and allocated to two groups according to surgery type: restrictive ( N = 18) and bypass group ( N = 31). One 7-day dietary record and one Kaiser questionnaire on PA were collected during the first and second trimester. Dietary quality was assessed using the Healthy Eating Index. Results: The diet quality did not change during pregnancy (restrictive group p = 0.050; bypass group p = 0.975) and was comparable between groups (first trimester p = 0.426; second trimester p = 0.937). During the first trimester, 15 % of the pregnant women had a healthy diet quality, 82 % had a diet that needed improvement, and 3 % had a poor diet quality. This was independent of surgery type and was comparable in the second trimester ( p = 0.525). No difference between groups was observed for the PA level, but the PA level in the bypass group significantly decreased from the first to the second trimester ( p = 0.033). Conclusions: Nutritional advice and lifestyle coaching in this high-risk population seems recommendable since only 15 % of the pregnant women had a healthy diet quality, 25 % was smoking at the beginning of pregnancy, and the reported PA levels were low. [ABSTRACT FROM AUTHOR]

Background: The obesity epidemic in developed countries has led to an increased prevalence of obese women of reproductive age. As maternal obesity has far-reaching consequences for both mother and child, the consensus is that weight loss before pregnancy will reduce obesity-related morbidity and mortality. Therefore, an increasing number of women become pregnant after undergoing obesity surgery.Results and Discussion: From the literature, data shows that perinatal outcome after bariatric surgery is generally considered as favourable for both mother and child. Only a few case reports highlight the possibility of side effects on the foetus and neonate. We report on five cases with severe intracranial bleeding, all possibly related to vitamin K deficiency following maternal bariatric surgery.Conclusion: These reports indicate that careful nutritional follow-up during pregnancy after obesity surgery is mandatory, because nutritional deficiencies such as vitamin K deficiency can lead to life-threatening bleeding. [ABSTRACT FROM AUTHOR]