Effects of a lifestyle intervention during pregnancy to prevent excessive gestational weight gain in routine care – the cluster-randomised GeliS trial

Abstract

BackgroundExcessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity. The GeliS study examines the effect of a lifestyle intervention during pregnancy on the proportion of women with excessive GWG and pregnancy and obstetric complications, as well as the long-term risk of maternal and infant obesity.MethodsThe GeliS study is a cluster-randomised multicentre controlled trial including 2286 women with a pre-pregnancy BMI between 18.5 and 40.0 kg/m2 recruited from gynaecological and midwifery practices prior to the end of the 12th week of gestation in five Bavarian regions. In the intervention regions, four lifestyle counselling sessions covering a balanced healthy diet, regular physical activity and self-monitoring of weight gain were performed by trained healthcare providers alongside routine pre- and postnatal practice visits. In the control regions, leaflets with general recommendations for a healthy lifestyle during pregnancy were provided.ResultsThe intervention did not result in a significant reduction of women showing excessive GWG (adjusted OR 0.95, 95% CI 0.66–1.38, p = 0.789), with 45.1% and 45.7% of women in the intervention and control groups, respectively, gaining weight above the Institute of Medicine recommendations. Gestational diabetes mellitus was diagnosed in 10.8% and 11.1% of women in the intervention and control groups, respectively (p = 0.622). Mean birth weight and length were slightly lower in the intervention group (3313 ± 536 g vs. 3363 ± 498 g, p = 0.020; 51.1 ± 2.7 cm vs. 51.6 ± 2.5 cm, p = 0.001).ConclusionIn the setting of routine prenatal care, lifestyle advice given by trained healthcare providers was not successful in limiting GWG and pregnancy complications. Nevertheless, the potential long-term effects of the intervention remain to be assessed.Trial registrationNCT01958307, ClinicalTrials.gov, retrospectively registered October 9, 2013.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1235-z) contains supplementary material, which is available to authorized users.

Maternal resveratrol administration protects against gestational diabetes‐induced glucose intolerance and islet dysfunction in the rat offspring

“…; Kunath et al . ). Therefore, there remains a role for natural health products that mimic some of the positive benefits of exercise and calorie restriction on maternal health for potential utilization in the setting of GDM.…”

“…Although lifestyle interventions remain the first line of treatment for GDM, their efficacy is often limited as a result of inconsistent adherence to these interventions and a lack of clear guidelines about exercise intensity during pregnancy Kunath et al 2019). Therefore, there remains a role for natural health products that mimic some of the positive benefits of exercise and calorie restriction on maternal health for potential utilization in the setting of GDM.…”

Evaluation of a computer-assisted multi-professional intervention to address lifestyle-related risk factors for overweight and obesity in expecting mothers and their infants: protocol for an effectiveness-implementation hybrid study

“…The development of the GeMuKi intervention has been informed by experiences from the project 9 + 12 [34] and the GeliS study [28][29][30]. It aims to positively influence lifestyle-related risk factors of expecting mothers and their infants.…”

“…Recent findings of the GeliS trial (acronym for "Gesund leben in der Schwangerschaft") conducted in the German state of Bavaria suggest that incorporating lifestyle counseling into routine prenatal health services is feasible and leads to high compliance rates [28]. The lifestyle intervention itself achieved only slight improvements in prenatal intake of food items, exclusive breastfeeding behavior and maternal post-partum weight development [29,30].…”

Study of Physical Activity and Dietary Interventions for Weight Management Before Pregnancy of Bulgarian Women

“…Health professionals should be com mitted to promoting a healthy lifestyle. Many authors study lifestyle interventions targeting diet, physical activity, and behavioral strategies in women with overweight and obesity who are about to become pregnant and giving birth (Phelan et al, 2018;Tanentsapf et al, 2011;Oteng-Ntim et al, 2012;Jiang et al, 2012;Kunath et al, 2019) The conception of this study is to determine the ex tent to which Bulgarian healthcare professionals are focusing the attention of women of reproductive age on the possibilities for weight management.…”