The effect of regular weighing and dietary advice on clinical outcomes and feelings in overweight pregnant women :Facts, figures and feelings about weight gain in pregnancy

INTERVENTION: Women in both groups will be weighed at recruitment, before 20 weeks gestation. Women in the control group will be advised of their body mass index (BMI), and recommended weight gain for pregnacy based on Institute of medicine guidelines. Women in the intervention group will have a single individual session lasting approximately 30 minutes with a dietitan or food technologist or trained midwife, consisting of a dietary history and simple dietary advice. They will be encouraged to weigh themselves regularly and record weight gain on a personalsed graph. Weight gain will be recorded in both groups at 36 weeks pregnancy CONDITION: Overweight in pregnancy PRIMARY OUTCOME: Composite maternal outcome of gestational diabetes, pregnancy induced hypertension (PIH), preeclampsia, eclampsia, mode of birth other than spontaneous vertex, shoulder dystocia, post partum haemorrhage (PPH) greater than 500ml, 3rd or 4th degree perineal trauma, admission to high dependency unit ( HDU ) or intensive care unit (ICU), postnatal stay birth suite greater than 6 hours, maternal death ; This will be assessed from the Birth Outcomes System (BOS) , review of medical notes if required, review of ICU admissions SECONDARY OUTCOME: Infant outcomes including birthweight, centiles, markers of adiposity, personalised centiles, gestational age, birth trauma, admission to special care nursery (SCN) or neonatal intensive care nursery (NICU), jaundice, hypoglycaemia (as defined by the treating team) Maternal C reactive protein, adiponectin, glucose tolerance, insulin in maternal blood Maternal well being ‐ World Health Organisation Quality of Life BREF (WHO QOLBREF) markers of insulin resistance in umbilical cord blood maternal weight and well being ‐ WHO ‐ BREFQOL INCLUSION CRITERIA: Pregnant women with body mass index (BMI) greater than 25kg/m2