What Are the Most Effective Behavioural Strategies in Changing Postpartum Women’s Physical Activity and Healthy Eating Behaviours? A Systematic Review and Meta-Analysis

Abstract

Successful implementation of postpartum lifestyle interventions first requires the identification of effective core components, such as strategies for behavioural change. This systematic review and meta-analysis aimed to describe the associations between behavioural strategies and changes in weight, diet, and physical activity in postpartum women. Databases MEDLINE, CINAHL, EMBASE, and PsycINFO were searched for randomised controlled trials of lifestyle interventions in postpartum women (within 2 years post-delivery). Strategies were categorised according to the Behaviour Change Technique Taxonomy (v1). Forty-six articles were included (n = 3905 women, age 23–36 years). Meta-analysis showed that postpartum lifestyle interventions significantly improved weight (mean difference −2.46 kg, 95%CI −3.65 to −1.27) and physical activity (standardised mean difference 0.61, 95%CI 0.20 to 1.02) but not in energy intake. No individual strategy was significantly associated with weight or physical activity outcomes. On meta-regression, strategies such as problem solving (β = −1.74, P = 0.045), goal setting of outcome (β = −1.91, P = 0.046), reviewing outcome goal (β = −3.94, P = 0.007), feedback on behaviour (β = −2.81, P = 0.002), self-monitoring of behaviour (β = −3.20, P = 0.003), behavioural substitution (β = −3.20, P = 0.003), and credible source (β = −1.72, P = 0.033) were associated with greater reduction in energy intake. Behavioural strategies relating to self-regulation are associated with greater reduction in energy intake.

Women’s Barriers to Weight Loss, Perception of Future Diabetes Risk and Opinions of Diet Strategies Following Gestational Diabetes: An Online Survey

“…Responders in this survey who were further postpartum showed better self-regulation in dealing with hunger than responders who had recently had a baby. These findings are consistent with recent evidence which shows that women who are less than two years postpartum benefit from lifestyle modification that includes strategies such as self-monitoring to improve behavioural regulation, setting and reviewing goals, and problem solving, rather than information provision to increase knowledge [ 27 ].…”

Preventing Type 2 Diabetes in Women with Previous Gestational Diabetes: Reviewing the Implementation Gaps for Health Behavior Change Programs

“…87,88 We did not find any differences in effect size between interventions due to frequency, timing, delivery mode, or setting. 87,88 This suggests that health professionals' delivery and behavior change techniques on self-regulation should be included in all diabetes prevention program for postpartum women, while the other intervention characteristics such as delivery mode or setting could be determined by contextual needs.…”

Tracking of Maternal Diet from Pregnancy to Postpregnancy: A Systematic Review of Observational Studies

“…A different approach to managing these groups of women might be worth investigating in future interventions. Future public health–promotion programs should build on existing knowledge ( 5 , 64 , 76 ), take into account socioeconomic inequalities, and aim to implement tailored and population-specific nutritional strategies and lifestyle interventions for women during and after pregnancy to improve nutrition-related health outcomes for mothers and their children.…”