Do lifestyle interventions during pregnancy have the potential to reduce long‐term postpartum weight retention? A systematic review and meta‐analysis

Abstract

Reducing postpartum weight retention is a promising strategy for addressing the rising prevalence of overweight and obesity in women. This systematic review and meta-analysis explored whether lifestyle interventions during pregnancy have the potential to reduce weight retention at 4 months postpartum and beyond. A search of five electronic databases for randomized controlled trials comparing the effect of weight-related lifestyle interventions beginning in pregnancy on postpartum weight retention to standard prenatal care groups was performed. Postpartum weight retention data was synthesized in a random-effects meta-analysis. Data from 14 studies of 7116 participants showed that the intervention group retained statistically significant less weight than the control group (weighted mean difference: −0.73 kg, 95% CI: −1.32 to −0.14, P = 0.015). Subgroup analysis showed this effect to be largest in studies with follow-ups from 4 to 6 months (weighted mean difference: −1.32 kg, 95% CI: −2.11 to −0.53, P = 0.001), but it remained significant until 12 months postpartum (weighted mean difference: −0.68 kg, 95% CI: −1.28 to −0.09, P = 0.023). In studies of women with a body mass index above 25.0 kg/m 2 , no significant intervention effect was observed. More high-quality studies with a follow-up beyond 12 months postpartum are needed.

Intuitive eating is associated with improved health indicators at 1-year postpartum in women with gestational diabetes mellitus

“…It is therefore of utmost importance to decrease weight retention and to improve glucose control in order to reduce diabetes risk in this population. Traditional lifestyle interventions that are used to manage weight and glucose control and to prevent the progression to diabetes in the postpartum period have, however, been unsatisfactory and their sustained effects are controversial (Brown et al, 2017;Michel et al, 2018). In order to reduce weight retention and improve glycemic control in women with GDM, eating intuitively could help to exert less cognitive control over eating and rely more on satiety cues, irrespective of current innate satiety cues, and help to eat in response to hunger and satiety signals.…”

“…Clinically, our results if confirmed by an intervention trial could help address the issue of postpartum weight retention in women with GDM. It could also help augment the management and prevention of diabetes in women with GDM and in the highrisk subgroups with prediabetes or overweight/obese, especially when results from several existing lifestyle interventions still remain controversial (Gilbert et al, 2019) and inconsistent (Brown et al, 2017;Goveia P et al, 2018;Michel et al, 2018). We studied the novel relationship between IE with BMI, weight retention and glycemic control during pregnancy and in the postpartum period up to 1 year postpartum in a longitudinal cohort of women with GDM.…”

Eating behaviors in relation to gestational weight gain and postpartum weight retention: A systematic review

“…As is regularly done in literature, 27,28 we allow a scope of 1 year after delivery, representing the long-term postpartum.…”

Role of gestational weight gain, gestational diabetes, breastfeeding, and hypertension in mother-to-child obesity transmission

“…Moreover, due to the increased global lifetime risk score of cardiovascular disease in the offspring of mothers with PIH, interventional studies set in populations of pregnant women focused on postpartum weight management and postpartum weight retention, without addressing children growth trajectory. 52,53 The protocols included in the meta-analyses differed in terms of interventions, targeted populations, gestational age at booking or duration of the intervention, and also returned insufficient evidence on the effectiveness of any given intervention in the management of gestational weight gain. Some studies addressed increased maternal risk, aiming at a reduction of GDM prevalence in vulnerable populations.…”