Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months

Abstract

Background/Objectives We previously reported results from a randomized trial showing that a behavioral intervention during pregnancy reduced excess gestational weight gain but did not impact maternal weight at 12 months. We now examine the longer-term effects of this prenatal intervention on maternal postpartum weight retention and toddler body-mass-index z scores (BMIz) over 36 months. Subjects/Methods Pregnant women (N = 264; 13.7 weeks’ gestation; 41.6% Hispanic) with overweight or obesity were randomized into usual care or prenatal intervention. Anthropometric assessments in mothers and toddlers occurred at baseline, 35 weeks’ gestation and after delivery at 6, 12, 18, 24, and 36 months. Results At 36 months, prenatal intervention vs. usual care had no significant effect on the proportion of participants who returned to their early pregnancy weight or below (33.3% vs. 39.5%; p = 0.12) and had no effect on the magnitude of weight retained (2.8 [0.8, 4.8] vs 3.0 kg [1.0, 4.9], respectively; mean difference = 0.14 [−3.0, 2.7]). There was also no statistically significant intervention vs. usual care effect on infant BMIz or skinfold changes over time; toddler BMIz increased by 1.4 [−1.7, 1.0] units in the intervention group and 1.6 [−1.2, 1.8] units in the usual care group from delivery to 36 months (difference = 0.16 [−0.32. 0.63]). The proportion of toddlers at risk for obesity at 36 months was similar in intervention and usual care groups (28/77 [36.4%] vs 30/80 [37.5%]; p = 0.77). Conclusions Compared with usual care, lifestyle intervention during pregnancy resulted in similar maternal and toddler anthropometric outcomes at 36-months postpartum in a diverse US sample of women with overweight and obesity. To sustain improved maternal weight management initiated during pregnancy, continued intervention during the postpartum years may be needed.

Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

“…Compared to this cohort data, however, we observed a higher rate of children with underweight, and a slightly lower rate of children with obesity (extremely underweight: 1.4%, underweight: 3.8%, obese: 2.9%) [ 41 ]. The missing evidence of a reduction in the rate of childhood overweight at 2 and 3 years of age by antenatal lifestyle counselling in the GeliS study is in accordance with findings from other studies [ 19 , 20 , 42 , 43 , 44 ], and supported by findings from two recent meta-analyses [ 23 , 24 ]. Louise et al [ 24 ] performed an individual patient meta-analysis on randomised controlled trials (RCTs) including women with overweight or obesity on childhood outcomes at 3–5 years of age.…”

“…However, these comparable large-scale trials [ 19 , 43 ] have only considered women with overweight and/or obesity, whereas we also included women with normal weight. Furthermore, none of the aforementioned studies [ 19 , 20 , 42 , 43 , 44 ] were conducted alongside routine care.…”

Maternal depressive symptom trajectories and associations with child feeding

“…This was a secondary analysis of data from the Healthy Beginnings/ Comienzos Saludables (HB/CS) study [ 38 , 39 ]. HB/CS was a controlled trial in which pregnant women were randomized to either a multicomponent intervention to reduce excess weight gain in pregnancy or a control group that received usual prenatal care.…”

Associations Between Technology Use, Responsive Feeding, and Child Temperament Among Prior Prenatal Intervention Participants

“…The intervention reduced excess gestational weight gain 24 but did not affect birth weight or mothers' or children's weight change between birth and 12 or 36 months postpartum. 25,26…”

“…The intervention reduced excess gestational weight gain 24 but did not affect birth weight or mothers' or children's weight change between birth and 12 or 36 months postpartum. 25,26 For the present follow-up study (the Mealtime for Toddlers study), all mothers who participated in the Healthy Beginnings/Comienzos Saludables study and whose children were 18 months of age were invited to participate in additional assessments. Participants were told that the focus of the study was to explore mothertoddler feeding interactions and risks for childhood obesity.…”