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Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention



This pilot study evaluated a cost neutral, integrated Special Supplemental Nutrition Program for Women Infants and Children (WIC) and obstetrical service model designed to prevent postpartum weight retention in obese women.


A sample of women who received benefits from the Johns Hopkins (JH) WIC program and prenatal care from the JH Nutrition in Pregnancy Clinic, which provides obstetrical care for women with a BMI ≥ 30 kg/m2, participated in the WICNIP randomized clinical trial. Intervention participants received enhanced nutrition services and education at five visits and during one phone call between delivery and 6 months postpartum. Control participants received standard WIC services. Weight data was collected for all participants at multiple time points: pre-pregnancy, delivery, and postpartum at 4, 6 weeks, 4, and 6 months. Maternal socio-demographic factors, obesity class and the number of education contacts received were also recorded.


Fifty-three African-American women were randomized into the intervention and control groups. Intervention participants retained significantly less gestational weight gain than control participants (3.0 ± 11.8 vs. 12.6 ± 20.4, p < 0.05). In both groups, participants with Class III obesity retained significantly less weight than participants in Classes I and II (p = 0.02).

Conclusions for Practice

An integrated WIC and obstetrical service model is feasible and can limit postpartum weight retention in obese women. Weight retention at 6 months postpartum between intervention and control participants was statistically significant. Further research should explore targeted interventions by obesity class to address weight retention for low-income, African American women who participate in WIC.

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We would like to recognize the efforts of Matthew Goldshore, MPH, Johns Hopkins University Bloomberg School of Public Health Doctoral Student and George Washington University Medical School Student, Johns Hopkins Hospital NIP physicians and staff, especially Diane Blahut Vizthum, Johns Hopkins WIC staff, especially Ms. Deborah Robinson and Ms. Shawn Darian, Johns Hopkins Hospital Data management staff, especially Clayton Sann, Johns Hopkins University Bloomberg School of Public Health students including: Laina Gagliardi; Victoria Elliot; Julia Quam; Lauren Rogers-Bell; Titilope Oduyebo; Mona Sobhani; Stephany Gabaud, Jenna Fahle and Caitlin Murphy.


Funding was provided by the Role of the WIC Program in Improving Periconceptional Nutrition: A small grants program. UCLA School of Public Health, Department of Community Health Sciences.

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Correspondence to Susan M. Gross.

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Gross, S.M., Augustyn, M., Henderson, J.L. et al. Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention. Matern Child Health J 22, 794–802 (2018).

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  • Postpartum weight retention
  • Gestational weight gain
  • Obesity
  • WIC
  • Nutrition