ABSTRACT
INTRODUCTION: Pre-eclampsia, defined as the development of hypertension and proteinuria after 20weeks gestation, carries significant maternal and foetal risk. Pre-pregnancy BMI is the most useful predictor of pre-eclampsia. As the prevalence of obesity increases, prevention of pre-eclampsia by weight management strategies needs to be trialed. AIMS AND OBJECTIVES: To review the randomised controlled trials studying clinical effectiveness of antenatal weight management interventions compared to routine care in decreasing the incidence of pre-eclampsia in women with BMI 26kg/m(2) or greater. METHODS: Electronic bibliographic databases were searched using a systematic search strategy to identify relevant trials. All trials involving weight management during pregnancy were considered. Using pre-determined inclusion criteria, six trials were included in this review and were independently assessed using standardised evaluation criteria. RESULTS: Three studies found a significant difference in gestational weight gain; amongst the intervention groups, the smallest was 5.0kg, whereas the largest was 13.6kg. In sub-group analysis, one trial found a significant difference in the incidence of pre-eclampsia between adherent (2/90) and non-adherent participants (5/26). However, no significant difference was found in the overall incidence of pre-eclampsia across all intervention and control groups. CONCLUSION: There was no evidence to suggest that antenatal weight management interventions were effective in reducing the incidence of pre-eclampsia in women with a BMI⩾26kg/m(2).
