Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial

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The increased prevalence of obesity in pregnant women in Australia ... is a significant public health concern. Obese women are at increased risk of serious perinatal complications and guidelines recommend weight gain restriction and additional care.

There is limited evidence to support the effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of midwifery care on restricting gestational weight gain in obese women to the recommended range.

The secondary aims of the study are to assess the impact of continuity of midwifery care on: women's experience of pregnancy care; women's satisfaction with care and a range of psychological factors.

Methods: A two arm randomised controlled trial (RCT) will be conducted with primigravid women recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI[greater than or equal to]30 who are less than 17 weeks gestation.

Women allocated to the intervention arm will be cared for in a midwifery continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women allocated to the control group will receive routine care in addition to the same informational leaflet.

Weight gain during pregnancy, standards of care, medical and obstetric information will be extracted from medical records ...

Increasingly, midwifery continuity models of care are being introduced in low risk maternity care, and information on their application in high risk populations is required. There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women who are obese and the findings from this project may have application in other maternity services.

A fantastic research study and I would be very interested to learn the results. It is well-known that continuity of midwifery care is beneficial for low-risk women; the unanswered question remains: how does continuity of midwifery and obstetric care benefit women with complicated pregnancies? My hunch is that this form of care is most beneficial for women and babies.

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