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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1396-1404 |
| Number of pages | 9 |
| Journal | Obesity |
| Volume | 26 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2018 |
Funding
See Commentary, pg. 1391. Funding agencies: 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 [Research Coordinating Unit]); 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, the Office of Behavioral and Social Science Research, the NIH Office of Disease Prevention, the Indian Health Service, and the Intramural Research Program of NIDDK contributed support. Additional support was received from the NIDDK Obesity Nutrition Research Centers (P30 DK026687, P30 DK072476, P30 DK56341), the National Center for Advancing Translational Sciences Clinical and Translational Science Awards (U54 GM104940, U54 MD007587, UL1 RR024992), the National Institute on Minority Health and Health Disparities (S21MD001830), and EXODIAB-Excellence in Diabetes Research in Sweden. Disclosure: LMR and CKM reported that one of the interventions being evaluated in the Expecting Success trial at Pennington Biomedical Research Center (the SmartMoms smartphone application) has a pending trademark and is available for licensure. The other writing group members declared no conflict of interest. Clinical trial registration: ClinicalTrials.gov identifiers NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, and NCT01812694. Received: 25 November 2017; Accepted: 6 June 2018; Published online 6 September 2018. doi:10.1002/oby.22250
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Endocrinology, Diabetes and Metabolism
- Endocrinology
- Nutrition and Dietetics
