A review of the integration of behaviour change methodologies in randomised controlled trial lifestyle interventions among overweight and obese women during pregnancy

Background: Maintaining healthy lifestyle behaviours during pregnancy is important for maternal and fetal health. Increasing rates of maternal obesity and excessive gestational weight gain are reportedly driven by poor dietary and physical activity habits and carry high risk of health consequences such as gestational diabetes, miscarriage and fetal macrosomia. Pregnancy is an influential period, presenting a unique opportunity to positively alter health behaviours in order to benefit the mother and fetus. This can be challenging within the existing capacities of standard health care provision. Inconsistencies exist throughout the literature on the effectiveness of dietary and physical activity interventions in pregnancy. Aims This review focuses on the use of psychologically derived behaviour change theories and techniques within dietary and physical activity interventions aiming to improve several pregnancy outcomes in overweight and obese women. Additionally, this paper examines the qualitative evidence surrounding the factors influencing behaviours in this specific obstetric population, and also, explores the use of mobile technologies as novel health behaviour change aids. Results: Randomised controlled trials of diet and physical activity interventions in overweight and obese pregnancies remain inconsistent with respect to behaviour change theories and techniques used, measurement of behaviours and success in behavioural and pregnancy outcomes. Qualitative evidence lends useful information which may benefit the design of future interventions, and trials using mobile health technologies are in their infancy. Conclusion: To draw conclusions, further evidence based, behaviourally structured RCTs are warranted to effectively alter antenatal behaviours, and identify successful behaviour change components within high‐risk obstetric groups for implementation within clinical settings.