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Open Access Study protocol

Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial

Cate Nagle1*, Helen Skouteris2, Anne Hotchin3, Lauren Bruce2, Denise Patterson4 and Glyn Teale5

Author Affiliations

1 School of Nursing and Midwifery, Deakin University, Geelong Waterfront campus, 1 Gheringhap St, Geelong Victoria, 3217, Australia

2 School of Psychology, Burwood campus, 221 Burwood Hwy, Burwood Victoria, 3125, Australia

3 Department of Obstetrics and Gynaecology, Barwon Health, Ryrie St, Geelong Victoria, 3215, Australia

4 Women's and Children's Program, Box Hill Hospital, Arnold St, Box Hill, Victoria, 3128, Australia

5 Department of Obstetrics and Gynaecology, Goulburn Valley Health, Graham St, Shepparton, Victoria, 3630, Australia

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BMC Public Health 2011, 11:174  doi:10.1186/1471-2458-11-174

Published: 22 March 2011

Abstract

Background

The increased prevalence of obesity in pregnant women in Australia and other developed countries is a significant public health concern. Obese women are at increased risk of serious perinatal complications and guidelines recommend weight gain restriction and additional care. There is limited evidence to support the effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of midwifery care on restricting gestational weight gain in obese women to the recommended range. The secondary aims of the study are to assess the impact of continuity of midwifery care on: women's experience of pregnancy care; women's satisfaction with care and a range of psychological factors.

Methods/Design

A two arm randomised controlled trial (RCT) will be conducted with primigravid women recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI≥30 who are less than 17 weeks gestation. Women allocated to the intervention arm will be cared for in a midwifery continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women allocated to the control group will receive routine care in addition to the same informational leaflet. Weight gain during pregnancy, standards of care, medical and obstetric information will be extracted from medical records. Data collected at recruitment (self administered survey) and at 36 weeks by postal survey will include socio-demographic information and the use of validated scales to measure secondary outcomes.

Discussion

Continuity of midwifery care models are well aligned with current Victorian, Australian and many international government policies on maternity care. Increasingly, midwifery continuity models of care are being introduced in low risk maternity care, and information on their application in high risk populations is required. There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women who are obese and the findings from this project may have application in other maternity services. In addition this study will inform a larger trial that will focus on birth and postnatal outcomes.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12610001078044.