Home-based lifestyle intervention minimizes maternal weight gain | Brown School at Washington University in St. Louis
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Home-Based Lifestyle Intervention Minimizes Maternal Weight Gain

Public Health; Faculty

​Weight gain during pregnancy and postpartum are important causes of long-term weight gain and the development of obesity-related diseases among women. A new, interdisciplinary study from Washington University in St. Louis finds providing a home-based lifestyle intervention effectively minimizes excess maternal weight gain during pregnancy and through 12 months postpartum in underserved African-American women with obesity.

“We’ve found that lifestyle interventions delivered through Parents as Teachers, a national home visiting organization, provide sustainable, scalable and effective weight management for underserved African-American women with overweight or obesity issues,” said first author Debra Haire-Joshu, the Joyce Wood Professor at the Brown School and an expert on interventions to reduce obesity and prevent diabetes among underserved women and children.

The findings were published March 22 as the Editor’s Choice article in the April issue of the journal Obesity.

This study was conducted at one site of the Lifestyle Interventions for Expectant Moms (LIFE-Moms) Consortium.

Analysis was conducted involving 185 African-American women with a Body Mass Index (BMI) of 25 to 45 at the onset of pregnancy. The study evaluated group differences between the standard Parents as Teachers curriculum and Parents as Teachers Plus, a lifestyle intervention embedded within the standard curriculum prenatally and for 12 months postpartum.

“Compared with the standard Parents as Teachers group, we found that the lifestyle intervention group gained less weight and was more likely to return to baseline weight from baseline to one year postpartum with minimal additional cost,” Haire-Joshu and colleagues wrote.

The authors noted that the prevalence of being overweight and obese is high among African-American women, particularly those who are underserved and socioeconomically disadvantaged. “Women with obesity are at risk of excessive gestational weight gain during pregnancy and have greater weight retention one year after delivery, thereby increasing the severity of their obesity and the risk of obesity-related medical issues,” the study said.

Although lifestyle intervention is recommended for pregnant women with obesity to prevent excessive gestational weight gain and postpartum weight retention, providing effective real-world therapy for socioeconomically disadvantaged women is difficult because of the many barriers to program participation related to parenting responsibilities, costs, limited transportation and other stressors.

“Excessive weight gain during pregnancy can have adverse long-term effects on child health,” said senior author Samuel Klein, the William H. Danforth Professor of Medicine and Nutritional Science and director  of the Division of Geriatrics and Nutritional Science at Washington University School of Medicine in St. Louis. “Additional studies are needed to determine whether minimizing gestational weight gain in women who are already obese has beneficial effects on their children.”

Haire-Joshu noted that Parents as Teachers, which has more than 3,200 sites across the United States, provides a sustainable and scalable program that helps provide effective weight management intervention for this high-risk population.


Haire-Joshu D, Cahill AG, Stein RI, Cade WT, Woolfolk CL, Mathur A, Schwarz CD, Schechtman KB, Klein S. Randomized controlled trial of home-based lifestyle therapy on postpartum weight in underserved women with overweight/obesity. Obesity, March 22, 2019.

This study was supported by the National Institutes of Health (NIH), grants DK94416, DK56341 (Nutrition Obesity Research Center); DK20579 (Diabetes Research Center); and RR024992 (Clinical and Translational Science Award). LIFE-Moms is supported by the NIH through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466 (RCU); the National Heart, Lung, and Blood Institute, U01 HL114344, U01 HL114377; the Eunice Kennedy Shriver National Institute of Child Health and Human Development, U01 HD072834; the National Center for Complementary and Integrative Health; the NIH Office of Research in Women’s Health; the Office of Behavioral and Social Science Research; the Indian Health Service; and the Intramural Research Program of the NIDDK.