Weighing In Pregnancy

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Overweight and obesity are the most common clinical risk factors affecting over 30% of the pregnancy population. Furthermore, excessive weight gain while pregnant also leads to increased morbidity and mortality for the woman and the fetus/neonate. The morbidity includes, for the fetus/neonate: macrosomia, shoulder dystocia, hypoglycemia and admission to the nursery and for the mother: high blood pressure, gestational diabetes, increased caesarean section rates and increased rates of overweight and obesity post pregnancy. A number of studies have targeted diet and exercise with varied effect. No study has focused on routinely weighing patients in clinic to provide regular feedback that may act as a positive behavioural component to limit weight gain. This study will investigate the effect of weighing pregnant patients at each antenatal clinic visit compared with routine care (weight recorded at the booking visit). All patients attending the Royal Women’s Hospital for their booking visit (<20weeks gestation) will be approached by a midwife or doctor. Only women planning to have all their antenatal care at the Royal Women's Hospital, and with no obvious medical problems, will be included. Once consented, patients will then be randomised into either the control or the intervention groups. Patients in the intervention group will be weighed at every antenatal visit until 36-38 weeks gestation, while the control group will receive routine care with a booking weight plus a weight at 36-38 weeks gestation. Information will be obtained about their demographics, previous pregnancies, medical problems and delivery. Participants will complete a questionnaire at the end of the study regarding their perception of being weighed. We will then analyse the mean pregnancy weight gain of the intervention group compared to the control group. We will also analyse the data according to the Body Mass Index (BMI) at entry to determine if particular subgroups of women (ie underweight, normal weight, overweight and obese) appear to have a different response to being weighed. We will also compare the neonatal outcomes to ensure there is no obvious harm in the process of regular weighing. This study will allow us to determine if weighing patients regularly does provide a positive behavioural component resulting in appropriate weight gain in pregnancy.

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