BACKGROUND AND PURPOSE: 

• Peaceman et al. (Obesity, 2018) sought to determine whether excess gestational weight gain (GWG) based on IOM recommendations can be improved with lifestyle intervention programs

METHODS: 

• Individual‐participant data meta-analysis  
• Seven separate randomized clinical trials tested different lifestyle intervention strategies to modify GWG in diverse populations 
  • Consortium of seven independent, collaborative clinical  trials that looked at lifestyle modifications during pregnancy 
• Lifestyle modifications included
  • Meal replacements | Modified Diabetes Prevention Program [DPP] intervention | Dietary Approaches to Stop Hypertension [DASH] diet | Smartphone‐based intervention | Parent–educator intervention 
• Women were randomized to receive either 
  • Lifestyle intervention program 
  • Standard care 
• Eligibility criteria, specific outcome measures, and assessment procedures were standardized across trials 
• Primary outcome: Excess GWG per week 
• Secondary outcomes: Other GWG measures as well as obstetrical and neonatal outcomes

RESULTS: 

• 1,150 women were randomized 
• Compared to the standard care group, the intervention group had a significantly lower percentage with excess GWG per week  
  • Intervention group: 61.8%   
  • Control group: 75.0% 
  • Odds ratio 0.52; 95% CI, 0.40 to 0.67 
• Total GWG from enrollment to 36 weeks’ gestation was also lower in the intervention group 
  • Intervention group: 8.1 ± 5.2kg 
  • Control group: 9.7 ± 5.4kg   
  • Mean difference: −1.59kg; 95% CI, −2.18 to −0.99kg  
• Results from the individual trials were similar 
• The intervention and standard care groups did not differ in  
  • Obstetrical outcomes: Preeclampsia | Gestational diabetes | Cesarean delivery | Birthweight 
  • Neonatal outcomes: Respiratory morbidity | Neonatal hypoglycemia | NICU admission

CONCLUSION: 

• Lifestyle intervention significantly lowered the proportion of women with excess gestational weight gain and reduced the odds of exceeding IOM recommendations by 48%  
• This study did not show significant difference in obstetrical and neonatal outcomes 
  • Interventions may be required earlier to have impact (e.g., preconception or first trimester)  
  • Studies may need to look at dietary content and body composition (e.g. fat vs muscle), not just weight gain

Learn More – Primary Sources: 

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

Related ObG Topics:

Recommended Weight Gain and Obesity Management in Pregnancy

Does Exercise During Pregnancy Impact Hypertension or Macrosomia?