Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial

Research output: Contribution to journalArticlepeer-review


External organisations

  • University of Oxford
  • University of Bristol


Objectives: To assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by United States Institute of Medicine).

Design: Randomised controlled trial.

Setting: Antenatal clinical in England.

Participants: Women between 10+0 and 14+6 weeks gestation, not requiring specialist obstetric care.

Interventions: Participants were randomised to usual antenatal care or usual care plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.

Primary and secondary outcome measures: Excessive gestation weight gain, depression, anxiety and physical activity.
Results 656 women from four maternity centres were recruited; 329 randomised to the intervention group and 327 to usual care. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted odds ratio 0.84, 95% CI: 0.53-1.33) in the intervention and usual care group respectively. There were no significant differences between the groups in anxiety and depression scores (anxiety: adjusted mean -0.50, 95% CI:-1.17-0.16; depression: adjusted mean -0.59, 95% CI:-1.23-0.05). There were no significant differences in physical activity scores between the groups.

Conclusions: A behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets, and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.

Trial registration: Current Controlled Trials registry number ISRCTN 67427351. 29th October 2014. http://www.isrctn.com/ISRCTN67427351.


Original languageEnglish
Article numbere030174
Number of pages10
JournalBMJ open
Issue number9
Publication statusPublished - 17 Sep 2019


  • pregnancy, weighing, midwives, weight