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Int J Obes (Lond). 2019 Jul 10. doi: 10.1038/s41366-019-0410-4. [Epub ahead of print]

One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials.

Author information

1
Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, CA, USA. sphelan@calpoly.edu.
2
The Biostatistics Center, George Washington University, Washington, DC, USA.
3
Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA.
4
Pennington Biomedical Research Center, Baton Rouge, LA, USA.
5
Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
6
The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
7
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
8
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
9
Phoenix Indian Medical Center, Indian Health Service, Phoenix, AZ, USA.
10
The National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
11
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO, USA.
12
Department of Nutrition, Harvard T.H. Chan Public Health School, Harvard University, Boston, MA, USA.
13
Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit Lund University Diabetes Centre, Skåne University Hospital Malmö, Malmö, Sweden.
14
New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
15
Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
16
Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
17
Center for Human Nutrition, Washington University in St. Louis, St. Louis, MO, USA.
18
Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.
19
Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
20
The Miriam Hospital and the Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, USA.

Abstract

BACKGROUND/OBJECTIVES:

Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores.

SUBJECTS/METHODS:

In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants.

RESULTS:

Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of -1.6 kg (95% CI -2.5, -0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months.

CONCLUSIONS:

Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.

PMID:
31292531
DOI:
10.1038/s41366-019-0410-4

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