Greater Neonatal Fat‐Free Mass and Similar Fat Mass Following a Randomized Trial to Control Excess Gestational Weight Gain

Abstract

ObjectiveTo determine the effectiveness of controlling maternal gestational weight gain in the second and third trimesters on neonate body composition.Methods210 healthy women with overweight (BMI ≥ 25 < 30) or obesity (BMI ≥30 kg/m2) randomized to a lifestyle intervention (LI) program focused on controlling gestational weight gain through nutrition and activity behaviors or to usual obstetrical care (UC). Infant fat and fat-free mass at birth were measured by air displacement plethysmography (PEAPOD) and by quantitative magnetic resonance (QMR).ResultsAt baseline, there were no between group differences in maternal characteristics (mean (±SD)): age 33.8 (±4.3) years, weight 81.9 (±13.7) kg, BMI 30.4 (±4.5) kg/m2, gestational age at randomization 14.9 (±0.8) wk. GWG was less in the LI group by 1.79 kg (p=0.003) or 0.0501 kg/wk (p=0.002). Compared to UC, LI infants had greater weight (131±59 g p=0.03), fat-free mass (98±45 g; p=0.03) by PEAPOD, and lean mass (105±38 g; p=0.006) by QMR. Fat mass and percentage fat were not significantly different.ConclusionIntervening in women with overweight and obesity through behaviors promoting healthy diet and physical activity to control gestational weight gain resulted in neonates with similar fat and greater fat-free mass.

Increased Visceral Adipose Tissue Without Weight Retention at 59 Weeks Postpartum

“…In the entire sample, LI GWG was 1.79 kg (standard error difference [SED] = 0.59 kg) less than in UC ( P < 0.003) . Among the women with overweight (25.0 ≥ BMI ≤ 29.9), LI GWG was not statistically lower than UC (−1.32 kg, SED = 0.70 kg, P = 0.06).…”

“…GWG in the third trimester did not differ (0.64 kg, SED = 0.38 kg, P = 0.09) between groups. Notably, in women with obesity, LI GWG was 69% of UC GWG (6.07 kg, SD = 4.24 kg vs. 8.75 kg, SD = 4.27 kg, SED = 0.96 kg, P < 0.007) . GWG per week above the Institute of Medicine guidelines was 19% in LI compared with 38% in UC ( P = 0.002) .…”

“…LIFT is in the Lifestyle Interventions For Expectant Moms (LIFE‐Moms) consortium consisting of seven independent randomized controlled trials (RCTs), a Coordinating Unit, and NIH as the sponsor, collaborating but with different strategies for reducing GWG in women with overweight or obesity. Described previously , LIFT was a parallel‐group RCT with women assigned in a 1:1 ratio at the beginning of the second trimester to a lifestyle intervention (LI) or to usual care (UC). A secondary hypothesis of LIFT was that maternal body fat and VAT would be lower for LI compared with UC.…”

Ganho De Peso Gestacional E Fatores Associados Em Gestantes E Recém-Nascidos

“…Segundo estudo, no entanto, mulheres com IMC pré-gestacional mais alto e baixa atividade física mostraram duas vezes mais chances de ter GPG excessivo (YONG et al, 2016). Sabe-se que intervenções comportamentais que melhorem a alimentação, juntamente com a prática de atividade física, atuam no controle do GPG (GALLAGHER et al, 2018). Sendo assim, acredita-se que a atividade física contribua para a manutenção e adequação do GPG, entretanto esta deverá ser associada a uma alimentação adequada, a qual não foi controlada no presente estudo.…”

Interventions During Pregnancy Reduce Excessive Gestational Weight Gain but Yield Unexpected Effects on Neonatal Body Composition

“…Both treatments were delivered by trained parent educators through home visits to socioeconomically disadvantaged African American women in St. Louis, Missouri. Gallagher et al adapted and integrated the Diabetes Prevention Program and the Look AHEAD: Action for Health in Diabetes curricula for pregnant women, using a 20‐module program that was delivered by a professional nutritionist at individual clinical visits in a racially diverse, highly educated sample in New York City. Control arm women received usual care that included a single visit with a nutritionist, and both treatment groups had an opportunity to attend different group sessions held every 8 weeks during pregnancy.…”