Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention

Matern Child Health J. 2018 Jun;22(6):794-802. doi: 10.1007/s10995-018-2449-6.

Abstract

Objective: This pilot study evaluated a cost neutral, integrated Special Supplemental Nutrition Program for Women Infants and Children (WIC) and obstetrical service model designed to prevent postpartum weight retention in obese women.

Methods: A sample of women who received benefits from the Johns Hopkins (JH) WIC program and prenatal care from the JH Nutrition in Pregnancy Clinic, which provides obstetrical care for women with a BMI ≥ 30 kg/m2, participated in the WICNIP randomized clinical trial. Intervention participants received enhanced nutrition services and education at five visits and during one phone call between delivery and 6 months postpartum. Control participants received standard WIC services. Weight data was collected for all participants at multiple time points: pre-pregnancy, delivery, and postpartum at 4, 6 weeks, 4, and 6 months. Maternal socio-demographic factors, obesity class and the number of education contacts received were also recorded.

Results: Fifty-three African-American women were randomized into the intervention and control groups. Intervention participants retained significantly less gestational weight gain than control participants (3.0 ± 11.8 vs. 12.6 ± 20.4, p < 0.05). In both groups, participants with Class III obesity retained significantly less weight than participants in Classes I and II (p = 0.02).

Conclusions for practice: An integrated WIC and obstetrical service model is feasible and can limit postpartum weight retention in obese women. Weight retention at 6 months postpartum between intervention and control participants was statistically significant. Further research should explore targeted interventions by obesity class to address weight retention for low-income, African American women who participate in WIC.

Keywords: Gestational weight gain; Nutrition; Obesity; Postpartum weight retention; WIC.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Child
  • Delivery of Health Care, Integrated
  • Feasibility Studies
  • Female
  • Food Assistance*
  • Gestational Weight Gain*
  • Humans
  • Infant
  • Obesity*
  • Pilot Projects
  • Postpartum Period
  • Poverty
  • Pregnancy
  • Prenatal Care*