Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes

Objective To study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methods A cohort study including a prospective intervent...

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Main Authors: Peter Damm, Björg Ásbjörnsdóttir, Marianne Vestgaard, Lene Ringholm, Lise Lotte Torvin Andersen, Dorte Møller Jensen, Elisabeth R Mathiesen
Format: Article
Language:English
Published: BMJ Publishing Group 2019-05-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/7/1/e000733.full
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author Peter Damm
Björg Ásbjörnsdóttir
Marianne Vestgaard
Lene Ringholm
Lise Lotte Torvin Andersen
Dorte Møller Jensen
Elisabeth R Mathiesen
author_facet Peter Damm
Björg Ásbjörnsdóttir
Marianne Vestgaard
Lene Ringholm
Lise Lotte Torvin Andersen
Dorte Møller Jensen
Elisabeth R Mathiesen
author_sort Peter Damm
collection DOAJ
description Objective To study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methods A cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.Results Ninety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2 vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), HbA1c in early pregnancy (6.7%±1.1% vs 6.5%±1.3% (50±12 mmol/mol vs 48±14 mmol/mol), p=0.32) and late pregnancy (5.9%±0.5% vs 6.0%±0.6% (41±6 mmol/mol vs 42±7 mmol/mol), p=0.34) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.Conclusions Motivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.Trial registration number NCT02883127.
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spelling doaj-art-2395ebd0ed444fb99c91f0a642d466cc2025-08-20T01:56:45ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972019-05-017110.1136/bmjdrc-2019-000733Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetesPeter Damm0Björg Ásbjörnsdóttir1Marianne Vestgaard2Lene Ringholm3Lise Lotte Torvin Andersen4Dorte Møller Jensen5Elisabeth R Mathiesen68 Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkCenter for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen Ø, DenmarkCenter for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen Ø, Denmark7 Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Gynaecology and Obstetrics, Odense University Hospital, Odense, DenmarkDepartment of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark6 Center for Pregnant Women with Diabetes, Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkObjective To study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methods A cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.Results Ninety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2 vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), HbA1c in early pregnancy (6.7%±1.1% vs 6.5%±1.3% (50±12 mmol/mol vs 48±14 mmol/mol), p=0.32) and late pregnancy (5.9%±0.5% vs 6.0%±0.6% (41±6 mmol/mol vs 42±7 mmol/mol), p=0.34) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.Conclusions Motivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.Trial registration number NCT02883127.https://drc.bmj.com/content/7/1/e000733.full
spellingShingle Peter Damm
Björg Ásbjörnsdóttir
Marianne Vestgaard
Lene Ringholm
Lise Lotte Torvin Andersen
Dorte Møller Jensen
Elisabeth R Mathiesen
Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
BMJ Open Diabetes Research & Care
title Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
title_full Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
title_fullStr Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
title_full_unstemmed Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
title_short Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
title_sort effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes
url https://drc.bmj.com/content/7/1/e000733.full
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