Lifestyle Intervention to Limit Excessive Weight Gain During Pregnancy in Minority Women
Lifestyle Intervention to Limit Excessive Weight Gain During Pregnancy in Minority Women
The prevalence of overweight and obesity is increasing among pregnant women in the United
 States. More than one-third of women of reproductive age in the US are overweight or obese,
 and two thirds of women gain more weight in pregnancy than is recommended by the Institute of
 Medicine guidelines. Maternal obesity during pregnancy increases the risk of complications to
 both mother and child. Minority women (Blacks and Hispanics) have higher rates of overweight
 and obesity when they become pregnant, experience higher rates of excessive weight gain
 during pregnancy, and experience higher rates of maternal and neonatal complications after
 adjusting for sociodemographic characteristics and comorbidities than Caucasian women.
 Epidemiologic studies indicate that lifestyle modification programs based on diet and
 exercise are promising approaches in controlling weight gain as well as in preventing type 2
 diabetes in populations at risk. We hypothesize that overweight/obese minority women (Blacks
 and Hispanics) assigned to a culturally-grounded lifestyle intervention program based on diet
 and moderate exercise will result in higher compliance with Institute of Medicine guidelines
 for weight gain than women receiving standard care. Such lifestyle modifications should
 reduce risk of maternal and neonatal complications. We propose 1) to determine whether a
 lifestyle intervention program, based on diet and moderate physical activity implemented
 shortly after first recognition of pregnancy, will result in higher compliance with Institute
 of Medicine guidelines for weight gain compared to women receiving standard care; 2) to
 determine the occurrence of carbohydrate intolerance and GDM at 24-28 weeks gestation (after
 the first 10-12 weeks of intervention) and at 6 weeks postpartum between women in the
 lifestyle intervention group and women receiving standard care; and 3) to explore the impact
 of the lifestyle intervention on the development of maternal and fetal complications during
 pregnancy. By limiting excessive weight gain, the lifestyle intervention program may prevent
 the burden of obesity-related complications during pregnancy and reduce risk of subsequently
 developing overt diabetes.
Inclusion Criteria:

 -  Blacks and Hispanic

 -  women between 18-45 years of age;

 -  2) overweight and obese (BMI > 25 kg/m2),

 -  3) have a sedentary lifestyle (<30 minutes/day of moderate physical activity), and

 -  4) prenatal care established at less than 20 weeks of gestation,

 -  5) with a singleton pregnancy.

 Exclusion Criteria:

 -  Women with 1) age < 18 or > 45 years,

 -  2) > 20 weeks gestation,

 -  3) history of diagnosis of type 2 diabetes, hypertension, cardiovascular disease,
 chronic renal disease, and active liver disease (AST > 3 ULN),

 -  4) anemia (hemoglobin < 10 g, hematocrit < 32%);

 -  5) current medications which adversely influence glucose tolerance (corticosteroids),

 -  6) multiple pregnancy,

 -  7) women not planning to continue pregnancy to term, 7) contraindications to
 participate in regular physical activity,

 -  8) patients with mental conditions rendering them unable to understand the nature,
 scope, and possible consequences of the study