Weight Management in Obese Pregnant Underserved African American Women



Status:Completed
Conditions:Obesity Weight Loss, Women's Studies
Therapuetic Areas:Endocrinology, Reproductive
Healthy:No
Age Range:18 - 45
Updated:2/7/2018
Start Date:October 2012
End Date:December 2017

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This project will test a novel lifestyle intervention to help overweight and obese
socioeconomically disadvantaged African American women achieve healthy weight control during
and after pregnancy and improve the health of their offspring. The treatment will be given
through an existing national home visiting program, Parents As Teachers (PAT), which will
facilitate sustainability and nationwide dissemination, if effective. We hypothesize that
compared with standard PAT monitoring and counseling (PAT), women randomized to the lifestyle
intervention program (PAT+) will have a lower percentage who exceed Institute of Medicine
recommendations for gestational weight gain.

Maternal overweight/obesity and inappropriate gestational weight gain increase both maternal
and neonatal morbidity and mortality. In addition, offspring of overweight/obese women are at
increased risk for neurodevelopmental delay, becoming obese, and developing metabolic
diseases. Women who are socioeconomically disadvantaged (SED), especially from African
American populations, are particularly susceptible to adverse pregnancy-related outcomes
because of their high prevalence rates of obesity. Therefore, successful weight management
during pregnancy in SED, African American women has considerable public health implications.
We have experience in testing lifestyle interventions among SED nonpregnant women that have
been implemented and sustained within community organizations such as Parents As Teachers
(PAT), a national home visiting program that provides parent-child education and services
free-of-charge to high-needs women, prenatally and post-partum, with up to 25 home visits per
year until kindergarten. We propose to conduct a 24-month (6-month prenatal and 18-month
post-partum) randomized, controlled trial in overweight and obese SED African American women
to evaluate the ability of an innovative lifestyle intervention program (PAT+), delivered by
PAT parent educators during prenatal and post-partum home visits, to improve maternal and
neonatal/infant weight, metabolic and health outcomes, relative to the standard PAT program
(PAT). A programmatic evaluation will determine the applicability of the PAT+ intervention in
real world settings by measuring programmatic reach, implementation, acceptability, and
sustainability. If effective, PAT+ can be disseminated through this national organization,
which currently reaches over 249,000 mothers and 319,000 children participating in 2,173 PAT
programs across all 50 states.

Inclusion Criteria:

- Pregnant, African American, Socioeconomically disadvantaged

- Established prenatal care at our clinic before 15-6/7 weeks gestation

- Singleton viable pregnancy

- Gestational age 9 to 15 weeks

- Body Mass Index (BMI) of 25-45 kg/m²

Exclusion Criteria:

- Diagnosis of diabetes prior to pregnancy, or test results suggestive of pre-pregnancy
diabetes

- Current use of certain medications

- Contraindications to aerobic exercise in pregnancy

- History of contraindicated medical conditions
We found this trial at
1
site
660 S Euclid Ave
Saint Louis, Missouri 63110
(314) 362-5000
Washington University School of Medicine Washington University Physicians is the clinical practice of the School...
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mi
from
Saint Louis, MO
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