"Fit for Delivery" is a randomized, controlled study to examine the effects of an intervention during pregnancy which consists of exercise groups and nutritional counselling. The investigators will assess the outcomes of gestational weight gain, postpartum weight retention, large newborns, glucose regulation, and the incidence of complications of pregnancy and delivery such as gestational diabetes and Cesarean section.
"Fit for Delivery" is a randomized, controlled study to examine the effects of an intervention during pregnancy which consists of exercise groups and nutritional counselling. The investigators intend to study 600 women who are expecting their first child, and include them in the study at the time of their first appointment at their local healthcare clinic, when they are between 12 and 20 weeks of pregnancy. All women who wish to participate will sign an informed consent. Women who are randomly assigned to the intervention group will receive two telephone consultations with nutritional advice on healthy eating during pregnancy. They will also be counselled about appropriate weight gain during pregnancy given their pre-pregnancy body mass index. They will be assigned to an exercise group which will meet twice a week for a specially designed workout, and will be encouraged to exercise once or twice weekly on their own. Women in the intervention group will also have access to a password-protected internet site with information on healthy living during pregnancy, and be invited to 2 or 3 evening classes with nutritional information. Women who are randomly assigned to the control group will receive routine pregnancy care. All women in the study will be studied using: * questionaires * two ultrasound examinations (at 30 and 36 weeks of pregnancy), * blood tests, including a 2 hour glucose challenge test, and measurement of hormones which regulate blood glucose levels * weighing of the participant, including use of a bioimpedance scale * weighing and measuring of her newborn baby, * blood tests from the umbilical cord, measuring hormones which regulate blood glucose levels * review of hospital records regarding mode of delivery, delivery complications and possible neonatal admissions for the newborn child. The investigators' hypothesis is that an intervention in the form of nutritional information and exercise groups will: 1. Affect the amount of weight women gain in pregnancy, and the amount of weight they retain 12 month after delivery 2. Affect the percentage of newborns who have a birthweight over 4 kilo, or who have a birthweight at or above the 90th percentile for Norwegian newborns. 3. Affect the blood sugar level and the incidence of gestational diabetes. 4. Affect the incidence of operative deliveries and the delivery by Cesarean section. 5. Affect the serum concentrations of hormones regulating blood sugar levels, measured in both participants and their newborns.
Two telephone consultations on nutritional topics and twice weekly exercise groups. Access to a password-protected internet site with information on healthy lifestyle during pregnancy. Two evening meetings with information on healthy pregnancy lifestyle.
Sorlandet Hospital
Kristiansand, Vest Agder, Norway
Maternal weight gain in pregnancy
weight gain in kg
Time frame: Measured at the time of delivery
Weight of the newborn
weight in grams at delivery
Time frame: Measured at the time of delivery
Maternal fasting serum glucose level
serum glucose
Time frame: Measured at gestational week 30
Incidence of operative delivery, both cesarean section and operative vaginal delivery
number of participants delivered by operative vaginal or cesarean section
Time frame: Assessed following delivery
Maternal body composition
Measured using bioimpedance scale
Time frame: Measured at 36 weeks of gestation
Maternal weight retention
weight change in kg from pre-pregnancy weight
Time frame: 12 months after delivery
Measurement of serum levels of hormones which regulate serum glucose levels, in both the pregnant woman and her newborn baby.
insulin, leptin
Time frame: Mother measured at gestational week 30, baby measured at delivery
Incidence of women with serum glucose levels >7.8 mmol/l after 2 hour glucose challenge test
results of glucose challege test
Time frame: Assessed at gestational week 30
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
606
Incidence of delivery complications
incidence of third and fourth degree tearing, hemmorhage
Time frame: Assessed following delivery
Proportion of newborns with birth weight over the 90th percentile for gestational age
weight at gestation, adjusted for population characteristics stratified by sex and gestational age
Time frame: Assessed following delivery