Abstract
BackgroundThe impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown.MethodsWe conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10+0 and 20+0 weeks and body mass index (BMI) ≥ 25 kg/m2 in early pregnancy were randomised to a diet and/or lifestyle intervention or continued standard antenatal care and in which longer-term maternal and child follow-up at 3–5 years of age had been undertaken. The primary childhood outcome was BMI z-score above the 90th percentile. Secondary childhood outcomes included skinfold thickness measurements and body circumferences, fat-free mass, dietary and physical activity patterns, blood pressure, and neurodevelopment.ResultsSeven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures.ConclusionsIn overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions.Trial registrationPROSPERO, CRD42016047165
Highlights
The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity
In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity
Of the 5180 women who participated in the original Randomised controlled trial (RCT), 4800 women were considered eligible to participate in the 3–5-year follow-up studies (Table 1)
Summary
The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. While the impact of maternal obesity extends beyond birth, being independently associated with an increased risk of early infant and childhood obesity [3], the extent to which the effect of maternal BMI may be modified by maternal diet and/or lifestyle remains unclear [2]. Global research efforts to date have focused on antenatal dietary and/or lifestyle interventions with the intention of limiting gestational weight gain (GWG) to improve health outcomes both for the woman and her infant. Longer-term childhood outcomes such as BMI and obesity were not included [4]
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