Mamas on Bedrest: Lifestyle Counseling May Improve Some Pregnancy Outcomes

June 2nd, 2011

Lifestyle Counseling May Improve Some Pregnancy Outcomes is the title of a Medscape continuing education module that I just completed. I am a staunch advocate of lots of support and education during pregnancy, so to see my belief somewhat validated was heartening to say the least.

In this particular study, Finnish researchers sought to determine if antenatal counseling of pregnant women at risk for developing Gestational Diabetes Mellitus (GDM) in mamas, reduce the birth weights in newborns born to mothers at risk for GDM and  effect ( avoid adverse) outcomes. 2271 Finnish women were enrolled in the study and screened with oral glucose tolerance tests between 8 and 12 weeks gestation. Women in the intervention group received individual intensified counseling regarding physical activity, diet, and weight gain at 5 antenatal visits.

The researchers found that intense counseling regarding diet, exercise and weight gain was effective in controlling birthweight of the newborns, but did not have an effect on whether or not a mother developed GDM.  The authors concluded,

“Results from ongoing clinical trials may strengthen the evidence on the effectiveness of lifestyle modifications on maternal and fetal hyperglycemia and its consequences,” the study authors conclude. “The findings of our study emphasize counseling on the topics of physical activity, diet, and weight gain in maternity care especially for women at risk for GDM in order to prevent LGA newborns possibly causing problems in delivery, and both the mother’s and the child’s later weight development.”

So while the authors did not reach their desired endpoint, lowering the incidence of gestational diabetes in women at risk, they did learn that counseling could in fact reduce the incidence of Large for Gestational Age infants and hence potentially reduce incidence of problems during delivery for both mother and baby.

Many researchers may read this study and conclude, “since there was no effect on incidence of GDM, then there is really no need to emphasize diet, exercise and weight management” during pregnancy. And it is with this attitude that I disagree. It has been my experience that women who are given no guidelines regarding their diets, how to exercise safely during pregnancy and counseled about appropriate weight gain during pregnancy do fare better and have fewer complications. I don’t have specific numbers so I cannot say that the results are statistically significant, but I have seen these results anecdotally. I prefer to educate pregnant women about their pregnancies and what they can do to make their pregnancies a little easier; to ease the nausea, pain and/or aches associated with pregnancy, to sleep better and to prepare as best possible for potential complications.

Many may argue that there is little evidence that counseling or coaching has any effect on a high risk pregnant woman, her pregnancy or her baby and that I am potentially coming between a pregnant woman and her health care provider. However, the women that I have had the opportunity to work with have been pleased and thankful to have someone with whom they can reach out to at all hours (via e-mail) and pose even those “silly questions”. They appreciate having someone who can point them to resources for more information and for many of the services that they may need.

If it takes a village to raise a child, I believe it takes that same village to support the mama who is going to give birth to that child. It’s in everyone’s best interest to ensure that pregnant women have all of the health care , support and resources that they need to have successful, uncomplicated (as much as possible) pregnancies and healthy babies.  We are all working towards the same goal, so let’s all work together to make it happen.

If you are pregnant, particularly if you are on bed rest and want to know what you can do to positively effect your situation, schedule a Complimentary 30 Minute Bedrest Breakthrough Session. It’s free and accessed by e-mailing info@mamasonbedrest.com.

The full Finnish study is available at PloS Medicine.

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