Abstract
BackgroundThe objectives of this study were to assess the efficacy of lifestyle intervention on gestational weight gain in pregnant women with normal and above normal body mass index (BMI) in a randomized controlled trial.MethodsA total of 116 pregnant women (<20 weeks of pregnancy) without diabetes were enrolled and 113 pregnant women completed the program. Participants were randomized into intervention and control groups. Women in the intervention group received weekly trainer-led group exercise sessions, instructed home exercise for 3-5-times/week during 20-36 weeks of gestation, and dietary counseling twice during pregnancy. Participants in the control group did not receive the intervention. All participants completed a physical activity questionnaire and a 3-day food record at enrolment and 2 months after enrolment.ResultsThe participants in the intervention group with normal pre-pregnancy BMI (≤24.9 kg/M2, n = 30) had lower gestational weight gain (GWG), offspring birth weight and excessive gestational weight gain (EGWG) on pregnancy weight gain compared to the control group (n = 27, p < 0.05). Those weight related-changes were not detected between the intervention (n = 27) and control group (n = 29) in the above normal pre-pregnancy BMI participants. Intervention reduced total calorie, total fat, saturated fat and cholesterol intake were detected in women with normal or above normal pre-pregnancy BMI compared to the control group (p < 0.05 or 0.01). Increased physical activity and reduced carbohydrate intake were detected in women with normal (p < 0.05), but not above normal, pre-pregnancy BMI at 2 months after the onset of the intervention compared to the control group.ConclusionThe results of the present study demonstrated that the lifestyle intervention program decreased EGWG, GWG, offspring birth weight in pregnant women with normal, but not above normal, pre-pregnancy BMI, which was associated with increased physical activity and decreased carbohydrate intake.Trial registrationNCT00486629
Highlights
The objectives of this study were to assess the efficacy of lifestyle intervention on gestational weight gain in pregnant women with normal and above normal body mass index (BMI) in a randomized controlled trial
The present randomized controlled trials (RCT) demonstrated that pregnant women with normal pre-pregnancy BMI, but not those with above normal pre-pregnancy BMI, had better weight-related pregnancy outcomes including excessive gestational weight gain (EGWG), gestational weight gain (GWG) and birth weight of offspring following the lifestyle intervention compared to the control group
The results from the present study support the findings that women with above normal pre-pregnancy BMI are relatively resistant to the lifestyle intervention in terms of GWG reported by Polley et al [13], which is possibly related to the response of the pregnant women to lifestyle education on food intake and physical activity
Summary
The objectives of this study were to assess the efficacy of lifestyle intervention on gestational weight gain in pregnant women with normal and above normal body mass index (BMI) in a randomized controlled trial. The guidelines of the Canadian Medical Association Institute for the management and prevention of obesity have recommended the measurement of both body mass index (BMI) and waist circumference to assess the level and distribution of adiposity in adults [4]. In Canada, it was estimated that approximately 8.6 million of adults with age >18 years were overweight and 5.5 million were obese in 2005 [5]. Pre-pregnancy BMI ≥25 or above normal BMI increases the risk of poor outcomes of pregnancy including gestational diabetes, preeclampsia, hypertension and cesarean section [7]
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