Preventing excessive gestational weight gain among African American women: a randomized clinical trial

OBJECTIVE: Evidence is lacking regarding effective weight control treatments in pregnancy for ethnic minority women with obesity. This study evaluated whether a technology-based, behavioral intervention could decrease the proportion of overweight or obese African American women who exceeded Institute of Medicine (IOM) guidelines for gestational weight gain. METHODS: We conducted a 2-arm pilot randomized clinical trial. Participants were 66 socioeconomically disadvantaged African American pregnant women (12.5 ± 3.7 weeks’ gestation; 36% overweight, 64% obese) recruited from 2 outpatient obstetric practices at Temple University between 2013 and 2014. We randomized participants to usual care (n = 33) or a behavioral intervention (n = 33) that promoted weight control in pregnancy. The intervention included: 1) empirically-supported behavior change goals; 2) interactive self-monitoring text messages; 3) biweekly health coach calls; and 4) skills training and support through Facebook. RESULTS: The intervention reduced the proportion of women who exceeded IOM guidelines compared to usual care (37% vs. 66%, p = 0.033). Intervention participants gained less weight during pregnancy (8.7 vs. 12.3 kg, adjusted mean difference −3.1 kg, 95% CI −6.2, −0.1). No group differences in neonatal or obstetric outcomes were found. CONCLUSIONS: The intervention resulted in lower prevalence of excessive gestational weight gain.