The Impact of a Structured Preconception Care Program on Pregnancy Outcomes in Women with Obesity: A Randomized Controlled Trial

Abstract

Background: Obesity increases the risk of adverse pregnancy outcomes. The efficacy of structured preconception care (PCC) for this population
is not well-established.
Objective: To evaluate the impact of a structured PCC program on pregnancy outcomes in women with obesity.
Methods: A randomized controlled trial included 250 women (BMI≥30) planning pregnancy. The intervention group (n=125) received a 6-
month PCC program (nutritional counseling, physical activity, psychosocial support) before conception. The control group (n=125) received
standard care. Primary outcome was a composite of gestational diabetes, preeclampsia, preterm birth, or macrosomia.
Results: The composite outcome occurred in 28.8% of the intervention group versus 48.0% of controls (RR 0.60; 95% CI 0.43-0.84; p=0.002).
Rates of gestational diabetes (12.0% vs 24.8%, p=0.008) and preeclampsia (4.8% vs 12.0%, p=0.04) were significantly lower in the intervention
group. Mean neonatal birthweight was lower (3250g vs 3450g, p=0.001) and maternal depression/anxiety scores at 28 weeks were significantly
improved in the intervention group.
Conclusion: A structured PCC program for women with obesity significantly reduces the risk of major pregnancy complications and improves
maternal and neonatal outcomes. This supports the implementation of preconception interventions in routine care.