Access to Nutritional Services and the Effect on Maternal Weight Gain

• Weight gain [ Time Frame: one year ] [ Designated as safety issue: No ]
  change in weight from baseline prepregnancy weight
  
  

• Birth weight [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  Weight of infant at the time of birth
  
  
• Fetal anomalies [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  Ultrasound findings of fetal anomalies or those detected at birth
  
  
• Hypertensive disease of pregnancy [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  Development of hypertensive disease during pregnancy
  
  
• Gestational diabetes [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  Development of gestational diabetes
  
  
• Neonatal intensive care admission [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  Admission to neonatal intensive care unit
  
  
• APGAR scores [ Time Frame: At birth ] [ Designated as safety issue: No ]
  Measurement at birth
  
  
• Mode of delivery [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  vaginal delivery or cesarean section
  
  
• Intrauterine Fetal Demise [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
  Death of fetus prior to delivery
  
  
• Neonatal Death [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  Death of neonate from birth to 28 days of life
  
  

The purpose of this study is to evaluate the effect of access to nutrition services on pregnancy outcomes in the obese urban population. Approximately one fourth of women in the United States are overweight and nearly one third are considered to be obese. Pregnancy places obese women at increased risk for several adverse events in the antepartum, intrapartum, and postpartum period. There are many studies that have shown that obesity in pregnancy has a negative impact on pregnancy. However, currently there are few studies in the United States that specifically look at ease of access to nutrition services in an obese urban population and the effect this has on pregnancy outcomes. This study will be a randomized controlled study that will compare two groups of pregnant women with a BMI of 30 or greater one of which has access to nutritional services along with routine prenatal care while the other gets only routine prenatal care. The investigators hypothesize that the obese parturient who has access to nutritional services will have decreased weight gain during pregnancy and ultimately have improved pregnancy outcomes. This will help to guide future care for the obese parturient in the urban population who may have limited access to services.