NCT03875300

Brief Summary

The investigators know that being overweight during pregnancy increases the health risks to both mum and baby. There is good evidence that diet or exercise, or both, during pregnancy can reduce excessive weight gain. The Best Start study aims to test the theory that obese pregnant women with a Body Mass Index (BMI) of 30 or over who participate in a structured programme of nutrition and lifestyle advice (Foodwise in Pregnancy ™) will achieve the recommended weight gain during pregnancy of no less than 5kg and no more than 9.1kg. The investigators would like to find out if pregnant women with a BMI of 30 or over who receive the Best Start intervention are more likely to effectively manage weight gain during pregnancy. To achieve this, the investigators will undertake a trial that randomly puts participants into an experimental group, or a control group, which will compare those who receive the intervention to those who continue with routine antenatal care. The investigators are aiming to recruit around 500 women during the study period. 250 will receive the Best Start intervention, and 250 will continue with routine antenatal care. The investigators would also like to find out if women who gain the recommended weight during pregnancy have better outcomes, compared to women who gain more or less weight. To do this the investigators will look at the routine information collected during antenatal and postnatal care, for both mum and baby. To do this regardless of the group clients are randomised to, the investigators will ask for permission to look at the routine information within the participants maternity record. This information includes, weight gained during pregnancy, whether the baby is born early, the type of labour and delivery, and any complications during the pregnancy or delivery that may have resulted in the need for additional care for mum or baby. The results of the study will be prepared for publication in scientific journals, and for presentation at scientific conferences. All participants will be able to obtain a copy of the results once they have been published and any information that could identify participants will be removed.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
526

participants targeted

Target at P75+ for not_applicable

Timeline
12mo left

Started Jul 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

4 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress90%
Jul 2017May 2027

Study Start

First participant enrolled

July 1, 2017

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 7, 2018

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

January 28, 2019

Completed
2 months until next milestone

First Posted

Study publicly available on registry

March 14, 2019

Completed
8.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2027

Expected
Last Updated

August 22, 2024

Status Verified

August 1, 2024

Enrollment Period

1.2 years

First QC Date

January 28, 2019

Last Update Submit

August 21, 2024

Conditions

Outcome Measures

Primary Outcomes (2)

  • Body Mass Index - Weight and height recordings will be used to calculate BMI in kg/m^2 at 12 weeks.

    Body Mass Index.

    12 weeks gestation.

  • Weight of participant recorded in kg at 36 weeks.

    The odds ratio of pregnant women with a BMI of ≥30 who do not gain excessive weight and achieve the optimum recommended weight gain during pregnancy of 5-9.1kg in the intervention group compared with the control group.

    36 weeks gestation.

Secondary Outcomes (19)

  • Number of babies born Pre-term - babies born <37 weeks.

    <37 weeks gestation

  • Number of participants identified with Pre-eclampsia - New hypertension presenting after 20 weeks of pregnancy with significant proteinuria.

    20 weeks +.

  • Number of participants identified with Thromboembolism - venous thromboembolism (VTE) - deep vein thrombosis(DVT) or pulmonary embolism (PE).

    Participant booking appointment to 4 weeks postpartum.

  • Mode of delivery - Caesarean section.

    Date of delivery.

  • Post surgical site infection - a type of healthcare associated infection in which a wound infection occurs after an invasive (surgical) procedure.

    Date of delivery to 4 weeks postpartum.

  • +14 more secondary outcomes

Other Outcomes (5)

  • Smoking status of study participant. Self reported measure and confirmed using piCObaby Smokerlyzer CO parts per million (PPM).

    Through study completion, an average of 1 year.

  • Folic acid compliance of study participant. Self reported measure. Pre-conception folic acid and early pregnancy folic acid at initial booking assessment. Recorded by Midwife.

    Through study completion, an average of 1 year.

  • Socio-economic status of study participant derived from Welsh Index of Multiple Deprivation (WIMD) using Postcode.

    Through study completion, an average of 1 year.

  • +2 more other outcomes

Study Arms (2)

Participants in the Intervention Group

EXPERIMENTAL

Intervention Group - will undertake a programme of 7 x 2 hour group sessions, following the scripted 'Foodwise in Pregnancy' manual of nutrition information; practical cooking sessions; and information on low impact exercise.

Behavioral: Foodwise in Pregnancy

Participants in the Control Group

NO INTERVENTION

Control Group - will continue with routine antenatal care, unchanged.

Interventions

A 7 week programme of nutrition and lifestyle advice, delivered in community venues by trained Healthy Lifestyle Support Workers (HLSWs). Participants must meet study inclusion criteria.

Participants in the Intervention Group

Eligibility Criteria

Age16 Years+
Sexfemale
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Pregnant women who at their early pregnancy dating scan (optimum time 12 weeks gestation, but with a tolerance of up to 16 full weeks gestation for women who book late) have a BMI of 30 or over and reside in Cwm Taf University Health Board area.
  • Aged over 16.
  • Capable of giving informed consent.
  • Singleton and multiple pregnancies.

You may not qualify if:

  • Pregnant women who at their early pregnancy dating scan (optimum time 12 weeks gestation, but with a tolerance of up to 16 full weeks gestation for women who book late) have a BMI of less than 29.9 and reside in Cwm Taf University Health Board area.
  • Aged under 16.
  • Incapable of giving informed consent.
  • Any women who have pre-existing diabetes, or develop gestational diabetes during their pregnancy.
  • Any health condition that means the health professional looking after the patient feels would contra-indicate involvement in this programme (e.g. losing the ability to consent during the programme)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Royal Glamorgan Hospital

Llantrisant, CF72 8XR, United Kingdom

Location

Prince Charles Hospital

Merthyr Tydfil, CF47 9DT, United Kingdom

Location

Ysbyty Cwm Cynon Hospital

Mountain Ash, CF45 4BZ, United Kingdom

Location

Ysbyty Cwm Rhondda Hospital

Tonypandy, CF40 2LX, United Kingdom

Location

MeSH Terms

Conditions

Pregnancy in Obesity

Interventions

Pregnancy

Condition Hierarchy (Ancestors)

Pregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesObesityOverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

ReproductionReproductive Physiological PhenomenaReproductive and Urinary Physiological Phenomena

Study Officials

  • Angela Jones

    Public Health Wales NHS Trust

    PRINCIPAL INVESTIGATOR
  • Angela Jones

    Public Health Wales NHS Trust

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomised Control Trial
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 28, 2019

First Posted

March 14, 2019

Study Start

July 1, 2017

Primary Completion

September 7, 2018

Study Completion (Estimated)

May 1, 2027

Last Updated

August 22, 2024

Record last verified: 2024-08

Data Sharing

IPD Sharing
Will share

Study findings will be disseminated via The Burdett Trust for Nursing, Cwm Taf University Health Board, Public Health Wales NHS Trust, health boards and interested clinicians and submission of a paper to a scientific journal for peer-review e.g. the British Journal of Midwifery. The results of our study will be prepared for publication in scientific journals, and for presentation at scientific conferences. All participants will be able to obtain a copy of the results once they have been published, no patient identifiable information will be included.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
It is anticipated that the initial study findings will be available for dissemination by approximately January 2021. The final Statistical Analysis Plan (SAP) is still to be determined.
Access Criteria
Access criteria is still to be determined.

Locations