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Obesity (Silver Spring). 2018 Sep;26(9):1396-1404. doi: 10.1002/oby.22250. Epub 2018 Sep 6.

Lifestyle Interventions Limit Gestational Weight Gain in Women with Overweight or Obesity: LIFE-Moms Prospective Meta-Analysis.

Author information

1
Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
2
The Biostatistics Center, George Washington University, Washington, DC, USA.
3
Department of Kinesiology, California Polytechnic State University, San Luis Obispo, California, USA.
4
New York Obesity Research Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
5
Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
6
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.
7
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
8
Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA.
9
Center for Clinical Research and Health Promotion, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
10
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
11
Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, Missouri, USA.
12
Phoenix Indian Medical Center, Indian Health Service, Phoenix, Arizona, USA.
13
Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital Malmö, Malmö, Sweden.
14
Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
15
Center for Human Nutrition, Washington University in St. Louis, St. Louis, Missouri, USA.
16
Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
17
Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
18
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.

Abstract

OBJECTIVE:

This study aimed to evaluate the effects of varied lifestyle intervention programs designed to ameliorate excess gestational weight gain (GWG) in pregnant women with overweight or obesity compared with standard care, including effects on pregnancy outcomes.

METHODS:

Seven clinical centers conducted separate randomized clinical trials to test different lifestyle intervention strategies to modify GWG in diverse populations. Eligibility criteria, specific outcome measures, and assessment procedures were standardized across trials. The results of the separate trials were combined using an individual-participant data meta-analysis.

RESULTS:

For the 1,150 women randomized, the percent with excess GWG per week was significantly lower in the intervention group compared with the standard care group (61.8% vs. 75.0%; odds ratio [95% CI]: 0.52 [0.40 to 0.67]). Total GWG from enrollment to 36 weeks' gestation was also lower in the intervention group (8.1 ± 5.2 vs. 9.7 ± 5.4 kg; mean difference: -1.59 kg [95% CI:-2.18 to -0.99 kg]). The results from the individual trials were similar. The intervention and standard care groups did not differ in preeclampsia, gestational diabetes, cesarean delivery, or birth weight.

CONCLUSIONS:

Behavioral lifestyle interventions focusing primarily on diet and physical activity among women with overweight and obesity resulted in a significantly lower proportion of women with excess GWG. This modest beneficial effect was consistent across diverse intervention modalities in a large, racially and socioeconomically diverse US population of pregnant women.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01545934 NCT01616147 NCT01771133 NCT01631747 NCT01768793 NCT01610752 NCT01812694.

PMID:
30230252
PMCID:
PMC6148360
DOI:
10.1002/oby.22250
[Indexed for MEDLINE]
Free PMC Article

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