Abstract
BackgroundExcessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity. The GeliS study examines the effect of a lifestyle intervention during pregnancy on the proportion of women with excessive GWG and pregnancy and obstetric complications, as well as the long-term risk of maternal and infant obesity.MethodsThe GeliS study is a cluster-randomised multicentre controlled trial including 2286 women with a pre-pregnancy BMI between 18.5 and 40.0 kg/m2 recruited from gynaecological and midwifery practices prior to the end of the 12th week of gestation in five Bavarian regions. In the intervention regions, four lifestyle counselling sessions covering a balanced healthy diet, regular physical activity and self-monitoring of weight gain were performed by trained healthcare providers alongside routine pre- and postnatal practice visits. In the control regions, leaflets with general recommendations for a healthy lifestyle during pregnancy were provided.ResultsThe intervention did not result in a significant reduction of women showing excessive GWG (adjusted OR 0.95, 95% CI 0.66–1.38, p = 0.789), with 45.1% and 45.7% of women in the intervention and control groups, respectively, gaining weight above the Institute of Medicine recommendations. Gestational diabetes mellitus was diagnosed in 10.8% and 11.1% of women in the intervention and control groups, respectively (p = 0.622). Mean birth weight and length were slightly lower in the intervention group (3313 ± 536 g vs. 3363 ± 498 g, p = 0.020; 51.1 ± 2.7 cm vs. 51.6 ± 2.5 cm, p = 0.001).ConclusionIn the setting of routine prenatal care, lifestyle advice given by trained healthcare providers was not successful in limiting GWG and pregnancy complications. Nevertheless, the potential long-term effects of the intervention remain to be assessed.Trial registrationNCT01958307, ClinicalTrials.gov, retrospectively registered October 9, 2013.
Highlights
Excessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity
Gestational diabetes mellitus was diagnosed in 10.8% of women allocated to the lifestyle intervention and 11.1% of women in the control group
Mean birth weight and length were slightly lower in the intervention group
Summary
Excessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity. In addition to a high pre-pregnancy BMI, excessive gestational weight gain (GWG) is an increasing public health concern due to its potential contribution to pregnancy and obstetric complications, maternal postpartum weight retention and childhood obesity. Pregnant women who gain weight excessively are more likely to develop gestational diabetes mellitus (GDM) [7, 8] and to retain weight in the postpartum period [9]. These risks affect overweight women or those with obesity, and those entering pregnancy with a normal BMI [8, 10, 11]. High GWG has been shown to raise the risk of childhood overweight and obesity [13, 14], especially in infants born to women with a normal pre-pregnancy BMI [15], which can persist later in life [16, 17]
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