Diet Versus Control Pregnant Barbadian Women Gestational Weight Gain Trial
Outcomes of Pregnant Barbadian Women With Obesity: A Case Controlled Prospective Study of Didactic Dietary Intervention Compared to a Standard Education Tool
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Tonya C Johnson, MBBS
- Phone Number: 4366450
- Email: obesityinpregnancystudy@gmail.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Woman over 18 years old
- Live singleton pregnancy
- BMI of greater than or equal to 35kg/m^2
- Registered patient of the Queen Elizabeth Hospital Antenatal Clinic
Exclusion Criteria:
- Presence of gestational diabetes or chronic diabetes mellitus,
- Have had bariatric surgery
- Do not speak english
- Pregnancy with a multiple gestation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Didactic Sessions
Women will receive online nutrition education by a registered dietitian, in addition to the same standard patient education tool as the other arm.
|
Three one-hour online nutrition group classes will be scheduled at 17, 21 and 29 weeks gestation (± 1 week).
Nutrient dense foods and beverages and limiting the intake of added sugars, sodium and saturated fat will be encouraged, as well as reading the nutrition facts label, individual goal setting and self-monitoring.
Physician recommended physical activity will be encouraged.
Food and beverage intake data will be measured by 24-hour dietary recalls collected on three non-consecutive days.
Data will be collected by telephone interview by a registered dietitian or dietary technician on four separate occasions: 16, 20 and 28 weeks gestation (± 1 week) and 36 weeks of gestation.
Details on portions consumed will be estimated using standard measuring cups and household utensils.
Nutrient intake will be generated using Vision Software Nutrient Analysis Software and the United States Department of Agriculture Food Composition Database, Food Data Central.
The standard patient education tool will take the form of a leaflet which will include 1.
A definition of body mass index 2.
A list of measures to be taken to limit weight gain in pregnancy.
3. A description of the major nutrients required in pregnancy (folate, iron, calcium, vitamin D and protein).
and 4.A description of the six food groups with recommendations for the number of servings per day.
|
|
Experimental: Education Tool
Women will receive a standard patient education tool in the form of a leaflet.
|
The standard patient education tool will take the form of a leaflet which will include 1.
A definition of body mass index 2.
A list of measures to be taken to limit weight gain in pregnancy.
3. A description of the major nutrients required in pregnancy (folate, iron, calcium, vitamin D and protein).
and 4.A description of the six food groups with recommendations for the number of servings per day.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean change in gestational weight in kilograms in each arm of the trial
Time Frame: From enrolment until delivery
|
Weight at or before delivery minus weight at enrolment
|
From enrolment until delivery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean neonatal birth weight in grams in each arm of the trial
Time Frame: Within one hour of birth
|
Weight of the neonate at birth
|
Within one hour of birth
|
|
Incidence of pregnancy induced hypertension in each arm of the trial
Time Frame: Beyond 20 weeks gestation and prior to delivery
|
New hypertension presenting after 20 weeks of pregnancy without significant proteinuria
|
Beyond 20 weeks gestation and prior to delivery
|
|
Incidence of gestational diabetes in each arm of the trial
Time Frame: Beyond 20 weeks gestation and prior to delivery
|
Defined using the National Diabetes Data Group (NDDG) criteria, which uses fasting, 1-hour, 2-hour, and 3-hour plasma glucose levels of 5.8mmol/L, 10.6mmol/L, 9.2mmol/L and 8.1mmol/L respectively diagnosed after 20 weeks gestation
|
Beyond 20 weeks gestation and prior to delivery
|
|
Incidence of primary post partum haemorrhage in each arm of the trial
Time Frame: Within 24 hours of delivery
|
The loss of 500 milliliters or more of blood from the genital tract within 24 hours of the birth of a baby.
Postpartum haemorrhage will be further subclassified as minor (blood loss 500-1000 ml) or major (blood loss more than 1000 ml)27.
Major postpartum haemorrhage will also be subdivided into moderate (1001-2000 ml) and severe (more than 2000 ml).
|
Within 24 hours of delivery
|
|
Incidence of low one minute APGAR score in each arm of the trial
Time Frame: After one minute of birth
|
Defined as a score less than seven
|
After one minute of birth
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rates of the various modes of delivery
Time Frame: At time of delivery
|
A qualitative variable described as vaginal delivery, assisted vaginal delivery or caesarean section and obtained from the patient's labour record
|
At time of delivery
|
|
Rates of Augmentation or Induction of labour
Time Frame: At the time of delivery
|
Augmentation of labour.
Induction of labour
|
At the time of delivery
|
|
Rates of preterm birth
Time Frame: From enrolment until delivery
|
Birth before 37 completed weeks of pregnancy
|
From enrolment until delivery
|
|
Rates of admission to Neonatal Intensive Care Unit
Time Frame: From birth to one week of life
|
A qualitative variable described as admitted or not admitted to the neonatal intensive care unit and obtained from the participant's infant medical record
|
From birth to one week of life
|
|
Rates of the presence of foetal malformation
Time Frame: From enrolment until delivery
|
A qualitative variable described as malformation present or not present and obtained form the participant's infant medical record
|
From enrolment until delivery
|
|
Rates of foetal death
Time Frame: From enrolment until delivery
|
A qualitative variable described as foetus dead or alive and obtained from the medical record of the participant or the medical record of the participant's infant.
|
From enrolment until delivery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Damian AJ Best, DM MRCOG MSc, University of the West Indies Cave hill Campus
Publications and helpful links
General Publications
- Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jorgensen JS. The LiP (Lifestyle in Pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care. 2011 Dec;34(12):2502-7. doi: 10.2337/dc11-1150. Epub 2011 Oct 4.
- Poston L, Bell R, Croker H, Flynn AC, Godfrey KM, Goff L, Hayes L, Khazaezadeh N, Nelson SM, Oteng-Ntim E, Pasupathy D, Patel N, Robson SC, Sandall J, Sanders TA, Sattar N, Seed PT, Wardle J, Whitworth MK, Briley AL; UPBEAT Trial Consortium. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2015 Oct;3(10):767-77. doi: 10.1016/S2213-8587(15)00227-2. Epub 2015 Jul 9.
- Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US); 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK32813/
- Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, Dietz PM. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007 Aug;30(8):2070-6. doi: 10.2337/dc06-2559a. Epub 2007 Apr 6.
- Satpathy HK, Fleming A, Frey D, Barsoom M, Satpathy C, Khandalavala J. Maternal obesity and pregnancy. Postgrad Med. 2008 Sep 15;120(3):E01-9. doi: 10.3810/pgm.2008.09.1920.
- Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One. 2013 Apr 16;8(4):e61627. doi: 10.1371/journal.pone.0061627. Print 2013.
- Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015 Aug;16(8):621-38. doi: 10.1111/obr.12288. Epub 2015 May 28.
- Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA. 2014 Apr 16;311(15):1536-46. doi: 10.1001/jama.2014.2269.
- Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). 2008 Mar;32(3):495-501. doi: 10.1038/sj.ijo.0803710. Epub 2008 Jan 29.
- Lima Ferreira J, Voss G, Doria M, Sa Couto A, Principe RM. Benefit of insufficient gestational weight gain in obese women with gestational diabetes mellitus: A multicenter study in Portugal. Diabetes Metab Syndr. 2021 Jan-Feb;15(1):419-424. doi: 10.1016/j.dsx.2021.01.020. Epub 2021 Feb 8.
- Olander EK, Hill B, Skouteris H. Healthcare Professional Training Regarding Gestational Weight Gain: Recommendations and Future Directions. Curr Obes Rep. 2021 Jun;10(2):116-124. doi: 10.1007/s13679-021-00429-x. Epub 2021 Feb 20.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Gestational Weight Gain Study
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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