Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials

摘要

Background Excessive gestational weight gain is associated with short and long-term adverse maternal and infant health outcomes, independent of pre-pregnancy body mass index. Weighing pregnant women as a stand-alone intervention during antenatal visits is suggested to reduce pregnancy weight gain. In the absence of effective interventions to reduce excessive gestational gain within the real world setting, this study aims to test if routine weighing as a stand-alone intervention can reduce total pregnancy weight gain and, in particular, excessive gestational weight gain. Methods A systematic review and meta–analysis of randomised controlled trials (RCTs) was conducted between November 2014 and January 2016, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seven databases were searched. A priori eligibility criteria were applied to published literature by at least two independent reviewers. Studies considered methodologically rigorous, as per the Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research, were included. Meta-analysis was conducted using fixed-effects models. Results A total of 5223 (non-duplicated) records were screened, resulting in two RCTs that were pooled for meta-analysis ( n =?1068 randomised participants; n =?538 intervention, n =?534 control). No difference in total weight gain per week was observed between intervention and control groups (weighted mean difference (WMD) -0.00?kg/week, 95% confidence interval (CI) -0.03 to 0.02). There was also no reduction in excessive gestational weight gain between intervention and control, according to pre-pregnancy body mass index (BMI). However, total weight gain was lower in underweight women ( n =?23, BMI?2) in the intervention compared to control group (?0.12?kg/week, 95% CI ?0.23 to ?0.01). No significant differences were observed for other pregnancy, birth and infant outcomes. Conclusion Weighing as a stand-alone intervention is not worse nor better at reducing excessive gestational weight gain than routine antenatal care.