My research program evaluates healthcare interventions in pregnancy and prior to conception to improve health outcomes for women and their babies. Overweight and obesity affects 50% of pregnant women across Australia and is a major contributor to poor pregnancy outcomes and health care costs. This impacts pregnancy and beyond, both for the woman and her child.
Traditionally, clinical focus has emphasised the need for maternal dietary modification with the intention of limiting gestational weight gain. In the first large scale RCT adequately powered to evaluate relevant clinical outcomes, we demonstrated that lifestyle intervention during pregnancy, in women with overweight and obesity, improved maternal diet but was ineffective in limiting gestational weight gain nor clinically impactful pregnancy, birth and child development outcomes.
This extensive body of research has culminated in two recent landmark publications. The first challenges the casual assumptions related to gestational weight gain and poor pregnancy outcomes, providing evidence for alternative avenues to address obesity in pregnancy. The second reports an innovative and comprehensive systematic review of the literature related to antenatal lifestyle interventions, concluding that the raft of evidence is heterogeneous, lacks robust critical analysis and ultimately, that such interventions are ineffective. A paradigm shift in clinical focus from interventions during pregnancy towards supporting women’s health before pregnancy is underway.