A Healthy Lifestyle Intervention During Pregnancy: Key To Preventing Chronic Disease Risk?

Abstract

Gestational hypertension disorders and diabetes affect 6-15% of all pregnancies worldwide and are associated with adverse maternal and neonatal outcomes that can have a programming effect on future chronic disease risk. Pregnant women who receive lifestyle interventions, including healthy eating and/or physical activity, may have a decreased risk of developing complications. PURPOSE: To analyze the effects of a supervised healthy lifestyle intervention (nutrition and exercise) during pregnancy on diagnosis of gestational diabetes, hypertension, caesarean delivery, stillbirth, macrosomia (babies > 4500g), and low birth weight (babies < 2500g) in a cohort in London, Canada. METHODS: From 2016 to 2019, 111 women were enrolled at 12-18 weeks gestation in the Nutrition and Exercise Lifestyle Intervention Program (NELIP; Clinical Trials #NCT02804061) up to delivery. The nutrition goals for the intervention were: 1) Submit a weekly 24 hour-food intake record; 2) Consume approximately 1800-2200 kcal/d; and 3) Consume 200-250 g carbohydrates/d (40-55% of total energy intake). The exercise goals were: 1) Duration of session: Walk for 25 minutes and add 2 minutes each week until 40 minutes were achieved and then maintain this walking duration until delivery; 2) Frequency: 3-4 times per week; and 3) Submit a weekly step log (pedometers were provided to each participant). RESULTS: As of October 2019, the average duration of the intervention was 20.9 ± 3.9 wks. Out of the 75 participants that completed the intervention, maternal age was 32.2 ± 3.3 yrs, self-reported pre-pregnancy weight was 71.2 ± 15.3 kg, and gestational age at delivery was 278.1 ± 9.0 days. No participants were diagnosed with gestational diabetes or hypertension. Data from 52 babies indicated: birth weight was 3456.0 ± 442.4 g and length was 50.7 ± 3.1 cm. None were born with low birth weight and there were no cases of stillbirth. The rate of macrosomia was 1.9% (n = 1) and caesarean delivery was 27% (n = 14). CONCLUSION: A healthy lifestyle intervention during pregnancy may help to prevent gestational diabetes and hypertension, and help to reduce the prevalence of stillbirth, macrosomia, low birth weight, and caesarean deliveries. Taken together, these findings may have major positive implications for the long-term health of both mothers and babies.