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Behavioral counseling can help pregnant patients limit excess weight gain, improve health outcomes

OHSU-led evidence review informs new U.S. Preventive Services Task Force recommendation to help manage, maintain healthy weight throughout pregnancy
Pregnant woman with barefoot standing on weight scales. Hands touching big belly. Close up. Point of view shot. Top view.
New report from OHSU informs new U.S. Preventive Services Task Force recommendation to help manage and maintain healthy weight throughout pregnancy. (Getty Images)

In the United States, 47% of people gain too much weight during pregnancy.

“While some weight gain is expected, excessive increases can lead to a higher risk for gestational diabetes, high blood pressure or cesarean deliveries, all of which can negatively impact birth outcomes,” says Aaron Caughey, M.D., Ph.D., M.P.P., M.P.H., professor and chair, Department of Obstetrics and Gynecology, and associate dean for women’s health research and policy, Oregon Health & Science University School of Medicine. “Additionally, pregnant people and their babies may become more susceptible to long-term health challenges such as obesity.”

In response to this growing trend, the U.S. Preventive Services Task Force – an independent panel of health care experts that work to improve overall health care outcomes --  today published a new recommendation statement on behavioral counseling interventions to support healthy weight and weight gain in pregnancy. The Task Force advises clinicians to offer pregnant patients effective counseling programs to help them manage and maintain a healthy amount of weight during the course of pregnancy.

“Pregnant people want to do the right thing for themselves and their babies. However, effectively managing weight gain isn’t easy, especially for those who may also be balancing a job or caring for other family members,” says Caughey, a Task Force member. “The Task Force found that clinicians can help their patients maintain a healthy weight by offering effective counseling interventions focused on nutrition, physical activity, and lifestyle or behavior changes.”

Close-in head shot of Amy Cantor, a smiling Caucasian woman with shoulder-length, straight brown hair.
Amy Cantor, M.D., M.P.H.

The recommendation was informed by an evidence review led by Amy Cantor, M.D., M.P.H., associate professor in the departments of Medical Informatics and Clinical Epidemiology, Family Medicine, and Obstetrics and Gynecology, OHSU School of Medicine.

Cantor and team found that behavioral and counseling-based interventions -- offered in different settings, formats and by a variety of clinicians, including registered dieticians, qualified fitness specialists, physiotherapists and health coaches -- are associated with healthier weight gain and decreased risk of pregnancy complications, including gestational diabetes, emergency cesarean delivery, or babies born with higher birth weight.

“In general, counseling sessions that took place consistently during the second and third trimesters were more effective than single or sporadic interventions,” says Cantor. “However, one type or method of intervention – whether in-person or virtual, nutrition-focused or activity-based – did not prove more effective than others. This suggests that a variety of counseling interventions can be successful, allowing multiple opportunities for clinicians and patients to identify the best options to fit their needs and lifestyle.”

The Task Force’s recommendation statement and accompanying evidence review have been published online in the Journal of the American Medical Association.

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