Access to Nutritional Services and the Effect on Maternal Weight Gain

The purpose of this study is to evaluate the effect of access to nutrition services on
pregnancy outcomes in the obese urban population. Approximately one fourth of women in the
United States are overweight and nearly one third are considered to be obese. Pregnancy
places obese women at increased risk for several adverse events in the antepartum,
intrapartum, and postpartum period. There are many studies that have shown that obesity in
pregnancy has a negative impact on pregnancy. However, currently there are few studies in
the United States that specifically look at ease of access to nutrition services in an obese
urban population and the effect this has on pregnancy outcomes. This study will be a
randomized controlled study that will compare two groups of pregnant women with a BMI of 30
or greater one of which has access to nutritional services along with routine prenatal care
while the other gets only routine prenatal care. The investigators hypothesize that the
obese parturient who has access to nutritional services will have decreased weight gain
during pregnancy and ultimately have improved pregnancy outcomes. This will help to guide
future care for the obese parturient in the urban population who may have limited access to
services.

Inclusion Criteria:

- primigravid women

- age 19-40yrs

- less than or equal to 18 weeks gestation at time of enrollment

- body mass index (BMI) greater than or equal to 30

Exclusion Criteria:

- multiparous women

- less than 19 yrs of age or older than 40

- greater than 18 weeks gestation at time of enrollment

- body mass index (BMI) less than 30

- any significant past medical history including hypertension, diabetes, renal disease,
coagulopathy

- past surgical history of gastric bypass/weight loss surgery