Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention
By Gross S, Augustyn M, Henderson J, Baig K, Williams C, Ajao B, Bell-Waddy P, Paige D
Objective: This pilot study evaluated a cost neutral, integrated Special Supplemental Nutrition Program for Women Infants and Children (WIC) and obstetrical service model designed to prevent postpartum weight retention in obese women.
Methods: A sample of women who received benefits from the Johns Hopkins (JH) WIC program and prenatal care from the JH Nutrition in Pregnancy Clinic, which provides obstetrical care for women with a BMI ≥ 30 kg/m2, participated in the WICNIP randomized clinical trial. Intervention participants received enhanced nutrition services and education at five visits and during one phone call between delivery and 6 months postpartum. Control participants received standard WIC services. Weight data was collected for all participants at multiple time points: pre-pregnancy, delivery, and postpartum at 4, 6 weeks, 4, and 6 months. Maternal socio-demographic factors, obesity class and the number of education contacts received were also recorded.
Results: Fifty-three African-American women were randomized into the intervention and control groups. Intervention participants retained significantly less gestational weight gain than control participants (3.0 ± 11.8 vs. 12.6 ± 20.4, p < 0.05). In both groups, participants with Class III obesity retained significantly less weight than participants in Classes I and II (p = 0.02).
Conclusions for Practice: An integrated WIC and obstetrical service model is feasible and can limit postpartum weight retention in obese women. Weight retention at 6 months postpartum between intervention and control participants was statistically significant. Further research should explore targeted interventions by obesity class to address weight retention for low-income, African American women who participate in WIC.
February 10, 2019
Gross S, Augustyn M, Henderson J, Baig K, Williams C, Ajao B, Bell-Waddy P, Paige D (2018) Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention. Maternal and Child Health Journal: Vol. 22, Issue 6, pp 794-802. Available online: https://doi.org/10.1007/s10995-018-2449-6