Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

the LIFE-Moms Research Group

doi:10.1016/j.diabres.2020.108549

Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

the LIFE-Moms Research Group

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m² and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.

Original language	English (US)
Article number	108549
Journal	Diabetes Research and Clinical Practice
Volume	171
DOIs	https://doi.org/10.1016/j.diabres.2020.108549
State	Published - Jan 2021

Funding

SP reports a grant from Weight Watchers International, outside the submitted work. LMR and CKM reported one of the interventions being evaluated in the Expecting Success trial at Pennington Biomedical Research Center (the SmartMoms™ smartphone application) is a licensed trademark and is available for licensure. The remaining authors have no other conflicts of interest to report. We thank the LIFE-Moms consortium members for their contributions to the development and oversight of the common measures and procedures shared across the trials. The LIFE-Moms Research Group: The following individuals and institutions are members of the LIFE-Moms Research Group (asterisks indicate principal investigators):, Clinical Centers. California Polytechnic State University & Brown University: S. Phelan*, R.R. Wing*, T.A. Hagobian, A. Schaffner, C. Hart, E.K. Yin, M.G. Phipps, B. Abrams, T.O. Scholl, D.A. Savitz, K. Munoz-Christian, E. Jelalian. St. Luke's-Roosevelt Hospital and Columbia University: D. Gallagher*, X. Pi-Sunyer*, B. Rosenn, C. Paley, S. Gidwani, M. Horowitz, J. Crane, S. Lin, J. Thornton, M. Holowaty, I. Janumala, J. Johnson, T. Toro-Ramos, E. Widen, W. Yu. University of Puerto Rico: K. Joshipura*, P.W. Franks*, M. Campos, M.A.Trak-Fellermeier, M. Mel?ndez C. Palacios, J. Pomeroy, I. Febo, J. Vergara, J. Rivera, K. M?ndez, R. Torres, S. Soltero, L. Ramos, V. Rivera, W.C. Willett, M.W. Gillman. Washington University in St. Louis: A.G. Cahill*, S. Klein*, D. Haire-Joshu*, R. Stein, A. Mathur, W.T. Cade. Northwestern University: A.M. Peaceman*, L. Van Horn*, M. Kwasny, J.L. Josefson, L. Neff, N. Gernhofer, E. Vincent, V. Vignolles, B. Spring. Pennington Biomedical Research Center: L.M. Redman*, C.K. Martin, K. Elkind-Hirsh, J. Breaux, D.S. Hsia, J.H. Burton, L.E. Cain, A.A. Altazan, E.F. Sutton, L.A. Gilmore. NIDDK/Phoenix Indian Medical Center: W.C. Knowler*, K.A. Couch*, J.M. Curtis, D.L. Dunnigan, B.A. Grice, R.L. Hanson, M.A. Hoskin, K.G. Kavena, C. Moffett, S. Murphy (deceased), J.A. Nelson, R.G. Nelson, J. Pomeroy, S. Sangster, J.R.M. Liao, L.A. Shovestull, S. K. Tanamas, R. Williams. Research Coordinating Unit, George Washington University Biostatistics Center: R.G. Clifton*, E.A. Thom*, K.L. Drews*, T. Boekhoudt. NIH: M. Evans (NIDDK), S.Z. Yanovski (NIDDK), S.S. Arteaga (NHLBI), D.L. Alekel (NCCIH, now at NIAMS), M. Miodovnik (NICHD), In addition, The LIFE-Moms Research Group thanks the following individuals who contributed to LIFE-Moms: A.C. Brannen, K, A. Quintana-Diaz, N Alarcon, M. LaSpina, M Legato, A Mercado, N Katsantones from Cal Poly; A. McHugh, J Duszlak, E Ferguson-Robichaud, D Fernandez-Pierre, K. DeLayo, K Story, P Sandoval, Z. Sylvia-Denmat, I. Cassell, M. LaRue from Brown University; K. Faulkner, K. Kelly, R. Koletsky, J. Patricio, J. Roman from St. Luke's-Roosevelt Hospital and Columbia University; I. Febo, A. Estampador, E. Rodr?guez, PRCTRC Personnel, I. Mat?as, C. Zorrilla from the University of Puerto Rico; A. Roy, D. Davis, T. Krasnitsky-Grott from Northwestern University; S.L. Dawson, G.Y. Kishi, L. Rodriguez, G. Clark, C.J. Dodge, T. Giles, J. Mcafee, and S. Huma from NIDDK/Phoenix Indian Medical Center. Data from the LIFE-Moms consortium will be deposited in the data repository of the National Institute of Diabetes, Digestive and Kidney Diseases in 2021. Data requests before this time should be directed to the contact author. Deidentified data will be shared following execution of data sharing agreements. LIFE-Moms is supported by the National Institutes of Health through The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466 (RCU)), The National Heart, Lung, and Blood Institute (NHLBI, U01 HL114344, U01 HL114377), and The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, U01 HD072834). In addition, the National Center for Complementary and Integrative Health (NCCIH), the NIH Office of Research in Women's Health (ORWH), the Office of Behavioral and Social Science Research (OBSSR), the NIH Office of Disease Prevention (ODP), the Indian Health Service and the Intramural Research Program of the NIDDK contributed support. Additional support was received from the NIDDK Obesity Nutrition Research Centers (P30 DK026687, P30 DK072476, P30 DK56341), National Center for Advancing Translational Sciences Clinical and Translational Science Awards (U54 GM104940, U54 MD007587, UL1 RR024992), National Institute on Minority Health and Health Disparities (S21MD001830) and EXODIAB-Excellence of diabetes research in Sweden. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SP reports a grant from Weight Watchers International, outside the submitted work. LMR and CKM reported one of the interventions being evaluated in the Expecting Success trial at Pennington Biomedical Research Center (the SmartMoms? smartphone application) is a licensed trademark and is available for licensure. The remaining authors have no other conflicts of interest to report. Drafted and/or critically reviewed the manuscript: Leanne M. Redman, William C Knowler, Kimberly L Drews, Mary Evans, Kaumudi Joshipura, Samuel Klein, Xavier Pi-Sunyer, Linda Van Horn, Rena Wing. Substantial contribution to the design, acquisition or interpretation of data: Leanne M. Redman, Kimberly L. Drews, Samuel Klein, Linda Van Horn, Rena Wing, Xavier Pi-Sunyer, Mary Evans, Kaumudi Joshipura, S. Sonia Arteaga, Alison G. Cahill, Rebecca G. Clifton, Kimberly A. Couch, Paul W. Franks, Dympna Gallagher, Debra Haire-Joshu, Corby K. Martin, Alan M. Peaceman, Suzanne Phelan, Elizabeth A. Thom, Susan Z. Yanovski, William C. Knowler, and the LIFE-Moms Research Group. Final approval: all listed authors.

Keywords

Clinical trials
Gestational diabetes mellitus
Lifestyle modification

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diabres.2020.108549

Cite this

@article{851751ba307f46d59dc8491a30e29c16,

title = "Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium",

abstract = "Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The {\textquoteleft}type of diagnostic test{\textquoteright} did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.",

keywords = "Clinical trials, Gestational diabetes mellitus, Lifestyle modification",

author = "{the LIFE-Moms Research Group} and Redman, {Leanne M.} and Drews, {Kimberly L.} and Samuel Klein and Horn, {Linda Van} and Wing, {Rena R.} and Xavier Pi-Sunyer and Mary Evans and Kaumudi Joshipura and Arteaga, {S. Sonia} and Cahill, {Alison G.} and Clifton, {Rebecca G.} and Couch, {Kimberly A.} and Franks, {Paul W.} and Dympna Gallagher and Debra Haire-Joshu and Martin, {Corby K.} and Peaceman, {Alan M.} and Suzanne Phelan and Thom, {Elizabeth A.} and Yanovski, {Susan Z.} and Knowler, {William C.}",

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier B.V.",

year = "2021",

month = jan,

doi = "10.1016/j.diabres.2020.108549",

language = "English (US)",

volume = "171",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

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T1 - Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

AU - the LIFE-Moms Research Group

AU - Redman, Leanne M.

AU - Drews, Kimberly L.

AU - Klein, Samuel

AU - Horn, Linda Van

AU - Wing, Rena R.

AU - Pi-Sunyer, Xavier

AU - Evans, Mary

AU - Joshipura, Kaumudi

AU - Arteaga, S. Sonia

AU - Cahill, Alison G.

AU - Clifton, Rebecca G.

AU - Couch, Kimberly A.

AU - Franks, Paul W.

AU - Gallagher, Dympna

AU - Haire-Joshu, Debra

AU - Martin, Corby K.

AU - Peaceman, Alan M.

AU - Phelan, Suzanne

AU - Thom, Elizabeth A.

AU - Yanovski, Susan Z.

AU - Knowler, William C.

PY - 2021/1

Y1 - 2021/1

N2 - Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.

AB - Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.

KW - Clinical trials

KW - Gestational diabetes mellitus

KW - Lifestyle modification

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Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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