Effect of Diet and Physical Activity–based Interventions in Pregnancy on Gestational Weight Gain and Pregnancy Outcomes

2018 ◽  
Vol 38 (2) ◽  
pp. 102
Author(s):  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Gestational Weight ◽  
Diet And Physical Activity ◽  
In Pregnancy

scholarly journals Gestational Weight Gain—Re-Examining the Current Paradigm

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2314
Author(s):  
Jennie Louise ◽  
Andrea R. Deussen ◽  
Jodie M. Dodd
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Obese Women ◽  
Gestational Weight ◽  
Diet And Physical Activity ◽  
Adverse Pregnancy

Our aim was to investigate the underlying assumptions of the current gestational weight gain (GWG) paradigm, specifically that—(1) GWG is modifiable through diet and physical activity; (2) optimal GWG and risk of excess GWG, vary by pre-pregnancy body mass index (BMI) category and (3) the association between GWG and adverse pregnancy outcomes is causal. Using data from three large, harmonized randomized controlled trials (RCTs) of interventions to limit GWG and improve pregnancy outcomes and with appropriate regression models, we investigated the link between diet and physical activity and GWG; the relationships between pre-pregnancy BMI, GWG and birth weight z-score; and the evidence for a causal relationship between GWG and pregnancy outcomes. We found little evidence that diet and physical activity in pregnancy affected GWG and that the observed relationships between GWG and adverse pregnancy outcomes are causal in nature. Further, while there is evidence that optimal GWG may be lower for women with higher BMI, target ranges defined by BMI categories do not accurately reflect risk of adverse outcomes. Our findings cast doubt upon current advice regarding GWG, particularly for overweight and obese women and suggest that a change in focus is warranted.

scholarly journals Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

BMJ ◽  
2017 ◽  
pp. j3119 ◽  
Author(s):  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Randomised Trials ◽  
Gestational Weight ◽  
Diet And Physical Activity ◽  
Individual Participant ◽  
Composite Outcomes

AbstractObjectiveTo synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women’s body mass index, age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications.DesignSystematic review and meta-analysis of individual participant data (IPD).Data sourcesMajor electronic databases from inception to February 2017 without language restrictions.Eligibility criteria for selecting studiesRandomised trials on diet and physical activity based interventions in pregnancy.Data synthesisStatistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall, and in subgroups (interactions).ResultsIPD were obtained from 36 randomised trials (12 526 women). Less weight gain occurred in the intervention group than control group (mean difference −0.70 kg, 95% confidence interval −0.92 to −0.48 kg, I2=14.1%; 33 studies, 9320 women). Although summary effect estimates favoured the intervention, the reductions in maternal (odds ratio 0.90, 95% confidence interval 0.79 to 1.03, I2=26.7%; 24 studies, 8852 women) and offspring (0.94, 0.83 to 1.08, I2=0%; 18 studies, 7981 women) composite outcomes were not statistically significant. No evidence was found of differential intervention effects across subgroups, for either gestational weight gain or composite outcomes. There was strong evidence that interventions reduced the odds of caesarean section (0.91, 0.83 to 0.99, I2=0%; 32 studies, 11 410 women), but not for other individual complications in IPD meta-analysis. When IPD were supplemented with study level data from studies that did not provide IPD, the overall effect was similar, with stronger evidence of benefit for gestational diabetes (0.76, 0.65 to 0.89, I2=36.8%; 59 studies, 16 885 women).ConclusionDiet and physical activity based interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. There is no evidence that effects differ across subgroups of women.

scholarly journals Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

2021 ◽  
Vol 10 (17) ◽  
pp. 3904
Author(s):  
Emmanuel Cosson ◽  
Sid Ahmed Bentounes ◽  
Charlotte Nachetergaele ◽  
Narimane Berkane ◽  
Sara Pinto ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Insulin Requirement ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
In Pregnancy

We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01–1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26–9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.

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