Abstract
BackgroundExcessive gestational weight gain (GWG) is associated with an increased risk of pregnancy and obstetric complications. The “healthy living in pregnancy” (GeliS) study was performed in a routine care setting with the aim of limiting excessive GWG. The purpose of this secondary analysis is to evaluate the effect of the intervention on physical activity (PA) behaviour and to assess the impact of PA intensities on GWG.MethodsThe cluster-randomised, multicentre GeliS trial was performed in a routine care setting alongside scheduled prenatal visits. Pregnant women with a pre-pregnancy BMI between 18.5 and 40.0 kg/m2 were either assigned to the control group receiving usual care or to the intervention group. Participants in the intervention group attended three antenatal counselling sessions on diet and PA and one additional postpartum session. Data on PA behaviour were collected twice, before the end of the 12th (baseline) and after the 29th week of gestation using the Pregnancy Physical Activity Questionnaire.ResultsPA data were available for 1061 (93%) participants in the intervention and 1040 (93%) in the control group. Women in the intervention group reported significant improvements in the levels of total PA (p < 0.001), total PA of light intensity and above (p < 0.001), moderate-intensity (p = 0.024) and vigorous-intensity activities (p = 0.002) as well as sport activities (p < 0.001) in late pregnancy compared to the control group. The proportion of women meeting the international PA recommendations in late pregnancy was significantly higher in the intervention (64%) versus the control group (49%, p < 0.001). Activities of light-intensity and above (p = 0.006), light-intensity (p = 0.002) and vigorous-intensity (p = 0.014) in late pregnancy were inversely associated with total GWG.ConclusionWe found significant evidence of improvements in the PA pattern of pregnant women receiving lifestyle counselling within the framework of routine care. Most PA intensities were inversely associated with total GWG which indicates that PA across different intensities should be promoted.Trial registrationNCT01958307, ClinicalTrials.gov, retrospectively registered 9 October, 2013.
Highlights
Excessive gestational weight gain (GWG) is associated with an increased risk of pregnancy and obstetric complications
The intervention observed no effect on excessive GWG, which was the main outcome of the GeliS trial [42], secondary analyses showed some positive effects of the intervention on intensity and type of reported physical activity (PA)
Despite improvements in the PA and dietary behaviour of participants [47], we found no evidence that the GeliS intervention succeeded in reducing the proportion of women with excessive GWG, we likewise focused on both lifestyle factors [42]
Summary
Excessive gestational weight gain (GWG) is associated with an increased risk of pregnancy and obstetric complications. Apart from associations with GWG, prenatal PA was shown to beneficially influence several physiological functions for instance in the cardiovascular and pulmonary systems [17, 18], and to lower the risk for pregnancy-induced complications such as GDM, preeclampsia and caesarean section [19,20,21,22]. PA often declines over the course of pregnancy [30, 31] This emphasises the need to develop interventions that address the prenatal lifestyle and include strategies to improve PA behaviour in order to reduce both excessive GWG and pregnancy-induced complications
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