Abstract
BackgroundPregnancy has been identified as a contributor to obesity. We have shown that a diet intervention postpartum produced a 2-y weight loss of 8%. Here, we present the impact of the diet intervention on cost-effectiveness and explore changes in quality of life (QOL).MethodsA total of 110 postpartum women with overweight/obesity were randomly assigned to diet (D-group) or control (C-group). D-group received a 12-wk diet intervention within primary health care followed by monthly emails up to the 1-y follow-up. C-group received a brochure. Changes in QOL were measured using the 36-item Short Form Health Survey and EQ-5D. The analysis of cost-effectiveness was a cost-utility analysis with a health care perspective and included costs of intervention for stakeholder, quality-adjusted life-years (QALYs) gained and savings in health care. The likelihood of cost-effectiveness was examined using the net monetary benefit method.ResultsThe D-group increased their QOL more than the C-group at 12 wk. and 1 y, with pronounced differences for the dimensions general health and mental health, and the mental component summary score (all p < 0.05). Cost per gained QALY was 1704–7889 USD. The likelihood for cost-effectiveness, based on a willingness to pay 50,000 USD per QALY, was 0.77–1.00.ConclusionsA diet intervention that produced clinically relevant postpartum weight loss also resulted in increased QOL and was cost-effective.Trial registrationClinical trials, NCT01949558, 2013-09-24
Highlights
Pregnancy has been identified as a contributor to obesity
Previous research has reported that most aspects of quality of life (QOL) are adversely affected by elevated body mass index (BMI), and that women with excess weight have lower QOL compared to men of corresponding BMI [3, 4]
The results showed that women randomized to diet intervention achieved a greater weight loss after 12 wk. (6.1 vs 1.6 kg, p < 0.001) and 1 y (10.0 vs 4.3 kg, p = 0.004) compared to the control group [17]
Summary
Pregnancy has been identified as a contributor to obesity. We have shown that a diet intervention postpartum produced a 2-y weight loss of 8%. Pregnancy has been identified as an important risk factor for the development and exacerbation of overweight and obesity [7]. This is mainly explained by excessive gestational weight gain and subsequent postpartum weight retention, which increase the risk of complications during succeeding pregnancies [8] and influence long-term maternal health [9, 10]. In addition to the reduced risk of maternal metabolic disease and future pregnancy complications [14], postpartum weight loss may have an immediate impact on QOL and health care costs [15, 16]. This information is critical to guide politicians and financers involved in decision-making processes about resource allocation
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