The increasing global problem of obesity in maternity
care has led to national guideline recommendations for
the development of interventions to improve pregnancy
outcomes.4,5 This advice stimulated many clinical trials,
predominantly of behavioural interventions addressing diet and physical activity. However, most trials have been
underpowered for clinical outcomes such as gestational
diabetes, focusing instead on restriction of gestational
weight gain.6
Nonetheless, systematic reviews of these
mostly small trials suggest the potential for prevention of
gestational diabetes in women with obesity by behaviour
change interventions in pregnancy.7,8
Here, we report the results of the UK Pregnancies
Better Eating and Activity Trial (UPBEAT), a randomised
controlled trial of a complex behavioural intervention
addressing diet and physical activity versus standard
antenatal care. The behavioural intervention was
designed to prevent maternal gestational diabetes and
reduce the incidence of large-for-gestational-age infants.
By contrast with interventions tested in many previous
small-scale studies,
the intervention was more intensive
in design. Findings of a pilot study have shown feasibility,
acceptability, and effi cacy of the intervention to change
lifestyle behaviours.