Effects of an antenatal dietary intervention in overweight and obese women on 6 month infant outcomes: follow-up from the LIMIT randomised trial

Abstract

BackgroundThe immediate impact of providing an antenatal dietary intervention during pregnancy has been extensively studied, but little is known of the effects beyond the neonatal period. Our objective was to evaluate the effect of an antenatal dietary intervention in overweight or obese women on infant outcomes 6 months after birth.MethodsWe conducted a follow up study of infants born to women who participated in the LIMIT trial during pregnancy. Live-born infants at 6-months of age, and whose mother provided consent to ongoing follow-up were eligible. The primary follow-up study endpoint was the incidence of infant BMI z-score ≥90th centile for infant sex and age. Secondary study outcomes included a range of infant anthropometric measures, neurodevelopment, general health, and infant feeding. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Missing data were imputed and analyses adjusted for maternal early pregnancy BMI, parity, study centre, socioeconomic status, age, and smoking status. Outcome assessors were blinded to the allocated treatment group.ResultsA total of 1754 infants were assessed at age 6 months (Lifestyle Advice n = 869; Standard Care n = 885), representing 82.1% of the eligible sample (n = 2136). There were no statistically significant differences in the incidence of infant BMI z-score ≥90th centile for infants born to women in the Lifestyle Advice group, compared with the Standard Care group (Lifestyle Advice 233 (21.71%) vs. Standard Care 233 (21.90%); adjusted relative risk (aRR) 0.99; 95% confidence interval 0.82 to 1.18; p = 0.88). There were no other effects on infant growth, adiposity, or neurodevelopment.ConclusionProviding pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention did not alter 6-month infant growth and adiposity. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).

The effectiveness of health professional‐delivered interventions during the first 1000 days to prevent overweight/obesity in children: A systematic review

“…After duplicate removal, and title and abstract screening, 230 references were selected for full‐text review. One hundred and eighty eligible studies were identified, describing 39 trials, comprising 46 interventions . Five trials had more than one eligible intervention arm .…”

“…We noted earlier that the number of interventions delivered during this period are increasing. More interventions focusing on maternal nutrition/physical activity/gestational weight gain are also now reporting infant follow‐up; only the ETOIG Trial had a positive impact on child adiposity/weight, however.…”

Effects of maternal lifestyle interventions on child neurobehavioral development: Follow‐up of randomized controlled trials

“…Our results are in line with one previous study showing no effect of a maternal lifestyle intervention during pregnancy in women with overweight or obesity on children's developmental level at the age of 6 months (Dodd, McPhee, Deussen et al ., ). No other similar follow‐up studies have been published about the development of older children or about children's behavior and therefore we have no basis for comparison of these findings.…”

The inheritance of cardiovascular disease risk

“…folic acid supplementation, smoking cessation), the trials to date aimed at modifying risk factors such as maternal BMI in pregnancy, fetal growth, infant adiposity or birthweight have met with only limited success (e.g. ). It is therefore important to look again at the life course trajectory of CVD risk and ask whether there is a phase during which interventions may be particularly valuable or efficacious.…”