Uncontrolled Eating during Pregnancy Predicts Fetal Growth: The Healthy Mom Zone Trial

Abstract

Excess maternal weight gain during pregnancy elevates infants’ risk for macrosomia and early-onset obesity. Eating behavior is also related to weight gain, but the relationship to fetal growth is unclear. We examined whether Healthy Mom Zone, an individually tailored, adaptive gestational weight gain intervention, and maternal eating behaviors affected fetal growth in pregnant women (n = 27) with a BMI > 24. At study enrollment (6–13 weeks gestation) and monthly thereafter, the Three-Factor Eating Questionnaire was completed. Ultrasounds were obtained monthly from 14–34 weeks gestation. Data were analyzed using multilevel modeling. Higher baseline levels of uncontrolled eating predicted faster rates of fetal growth in late gestation. Cognitive restraint was not associated with fetal growth, but moderated the effect of uncontrolled eating on fetal growth. Emotional eating was not associated with fetal growth. Among women with higher baseline levels of uncontrolled eating, fetuses of women in the control group grew faster and were larger in later gestation than those in the intervention group (study group × baseline uncontrolled eating × gestational week interaction, p = 0.03). This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy to demonstrate potential effects on fetal growth. Results also suggest that it may be important to develop intervention content and strategies specific to pregnant women with high vs. low levels of disinhibited eating.

Associations between Stress, Body Mass Index, Demographics and Eating Behaviors in Low-Income Overweight or Obese Women

“…Uncontrolled eating has been associated with higher caloric intake [32]. Also, uncontrolled eating during pregnancy predicts faster fetus growth, a risk of macrosomia (large baby for the gestational age) [43]. Prior research has reported the link between uncontrolled eating and obesity in low-income postpartum women with all body sizes [25], which is contradictory to our finding.…”

Associations between lifestyle interventions during pregnancy and childhood weight and growth: a systematic review and meta-analysis

“…Also, 110 study authors were contacted for unpublished data. Among them, 12 provided study data [40][41][42][43][56][57][58][59][60][61][62][63][64][65]. In total, this systematic review included 20 RCTs [40-43, 45-52, 56-63], of which 19 were synthesized in meta-analyses.…”

“…The 17 individually- [41, 42, 45-52, 56-60, 62, 63] and three cluster-RCTs [40,43,61] contributed data of 11, 385 randomized participants from 11 different countries (Table 1). Sample sizes at randomization ranged from 31 to 2286 participants [43,60]. Children were followed-up from 1 month to 7 years postpartum.…”

“…Children were followed-up from 1 month to 7 years postpartum. Women of all BMI classes were recruited in eight [40, 43, 45, 56-58, 62, 63], women with overweight or obesity in six [41,46,48,49,59,60], and women with obesity in three studies [50][51][52]. Two studies exclusively included women with risk factors for gestational diabetes mellitus [42,61], and one study limited eligibility to women who had previously given birth to a macrosomic infant [47].…”

Relationship between psychological stress and ghrelin concentrations in pregnant women with overweight or obesity

“…This is an important area for future research to consider as it is as yet unknown if maternal stress-induced alterations in ghrelin concentrations translate to unhealthy eating patterns and reduced diet quality in pregnant women, which in turn could influence pregnancy outcomes. For example, emerging evidence suggests that emotional or disinhibited eating behaviors may be associated with excess gestational weight gain (Blau et al, 2018) and rapid fetal growth (Savage et al, 2019), although this is an area of research requiring further investigation.…”