scholarly journals Effects of a Lifestyle Intervention in Routine Care on Short- and Long-Term Maternal Weight Retention and Breastfeeding Behavior—12 Months Follow-up of the Cluster-Randomized GeliS Trial

2019 ◽  
Vol 8 (6) ◽  
pp. 876 ◽  
Author(s):  
Julia Hoffmann ◽  
Julia Günther ◽  
Lynne Stecher ◽  
Monika Spies ◽  
Dorothy Meyer ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Exclusive Breastfeeding ◽  
Maternal Obesity ◽  
Routine Care ◽  
Control Group ◽  
Weight Retention ◽  
Maternal Weight ◽  
Increased Risk ◽  
Postpartum Weight ◽  
Cluster Randomized

Postpartum weight retention (PPWR) is associated with an increased risk for maternal obesity and is discussed to be influenced by breastfeeding. The objective was to evaluate the effect of a lifestyle intervention delivered three times during pregnancy and once in the postpartum period on PPWR and on maternal breastfeeding behavior. In total, 1998 participants of the cluster-randomized “healthy living in pregnancy” (GeliS) trial were followed up until the 12th month postpartum (T2pp). Data were collected using maternity records and questionnaires. Data on breastfeeding behavior were collected at T2pp. At T2pp, mean PPWR was lower in women receiving counseling (IV) compared to the control group (C) (−0.2 ± 4.8 kg vs. 0.6 ± 5.2 kg), but there was no significant evidence of between-group differences (adjusted p = 0.123). In the IV, women lost more weight from delivery until T2pp compared to the C (adjusted p = 0.008) and showed a slightly higher rate of exclusive breastfeeding (IV: 87.4%; C: 84.4%; adjusted p < 0.001). In conclusion, we found evidence for slight improvements of maternal postpartum weight characteristics and the rate of exclusive breastfeeding in women receiving a lifestyle intervention embedded in routine care, although the clinical meaning of these findings is unclear.

scholarly journals Effects of a Lifestyle Intervention in Routine Care on Prenatal Dietary Behavior—Findings from the Cluster-Randomized GeliS Trial

2019 ◽  
Vol 8 (7) ◽  
pp. 960 ◽  
Author(s):  
Julia Günther ◽  
Julia Hoffmann ◽  
Julia Kunath ◽  
Monika Spies ◽  
Dorothy Meyer ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Soft Drink ◽  
Intervention Group ◽  
Dietary Behavior ◽  
Late Pregnancy ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Weight Retention ◽  
Maternal Weight ◽  
Cluster Randomized

The antenatal lifestyle and excessive gestational weight gain (GWG) modify the risk of obstetric complications, maternal weight retention, and the risk of obesity for the next generation. The cluster-randomized controlled “Healthy living in pregnancy” (GeliS) study, recruiting 2286 women, was designed to examine whether a lifestyle intervention reduced the proportion of women with excessive GWG. Trained healthcare providers gave four counseling sessions covering a healthy diet, regular physical activity, and self-monitoring of GWG in the intervention group. In this secondary analysis, the effect on maternal dietary behavior was analyzed. Dietary behavior was assessed by means of a 58-item food frequency questionnaire in early and late pregnancy. The intervention resulted in a significant reduction in soft drink intake (p < 0.001) and an increase in the consumption of fish (p = 0.002) and vegetables (p = 0.023). With the exception of higher percentage energy from protein (p = 0.018), no effects of the intervention on energy and macronutrient intake were observed. There was no evidence for an overall effect on dietary quality measured with a healthy eating index. Some dietary variables were shown to be associated with GWG. In a routine prenatal care setting in Germany, lifestyle advice modified single aspects of dietary behavior, but not energy intake or overall dietary quality.

scholarly journals Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months

2021 ◽  
Author(s):  
Suzanne Phelan ◽  
Chantelle N. Hart ◽  
Elissa Jelalian ◽  
Karen Muñoz-Christian ◽  
Noemi Alarcon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Usual Care ◽  
Lifestyle Intervention ◽  
Body Mass ◽  
Overweight And Obesity ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Maternal Weight ◽  
Postpartum Weight ◽  
Prenatal Intervention

Abstract Background/Objectives We previously reported results from a randomized trial showing that a behavioral intervention during pregnancy reduced excess gestational weight gain but did not impact maternal weight at 12 months. We now examine the longer-term effects of this prenatal intervention on maternal postpartum weight retention and toddler body-mass-index z scores (BMIz) over 36 months. Subjects/Methods Pregnant women (N = 264; 13.7 weeks’ gestation; 41.6% Hispanic) with overweight or obesity were randomized into usual care or prenatal intervention. Anthropometric assessments in mothers and toddlers occurred at baseline, 35 weeks’ gestation and after delivery at 6, 12, 18, 24, and 36 months. Results At 36 months, prenatal intervention vs. usual care had no significant effect on the proportion of participants who returned to their early pregnancy weight or below (33.3% vs. 39.5%; p = 0.12) and had no effect on the magnitude of weight retained (2.8 [0.8, 4.8] vs 3.0 kg [1.0, 4.9], respectively; mean difference = 0.14 [−3.0, 2.7]). There was also no statistically significant intervention vs. usual care effect on infant BMIz or skinfold changes over time; toddler BMIz increased by 1.4 [−1.7, 1.0] units in the intervention group and 1.6 [−1.2, 1.8] units in the usual care group from delivery to 36 months (difference = 0.16 [−0.32. 0.63]). The proportion of toddlers at risk for obesity at 36 months was similar in intervention and usual care groups (28/77 [36.4%] vs 30/80 [37.5%]; p = 0.77). Conclusions Compared with usual care, lifestyle intervention during pregnancy resulted in similar maternal and toddler anthropometric outcomes at 36-months postpartum in a diverse US sample of women with overweight and obesity. To sustain improved maternal weight management initiated during pregnancy, continued intervention during the postpartum years may be needed.

scholarly journals Longer duration of exclusive breastfeeding reduces maternal weight retention: results from the CLaB study

2020 ◽  
Vol 20 (1) ◽  
pp. 273-284
Author(s):  
Michelly da Silva Alves ◽  
Maiara Aparecida Mialich Almeida ◽  
Caroline de Barros Gomes ◽  
Anna Paula Ferrari ◽  
Cristina Maria Garcia de Lima Parada ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Post Partum ◽  
Descriptive Analysis ◽  
Breastfeeding Duration ◽  
Weight Retention ◽  
Linear Regression Models ◽  
Maternal Weight ◽  
Postpartum Weight ◽  
The Mean ◽  
First Interview

Abstract Objectives: to evaluate the relation between breastfeeding and postpartum weight reten-tion. Methods: this prospective cohort study involved 641 newborns and their mothers, followed up to twelve months postpartum. Data were collected from June 2015 to February 2017. In the first interview, we investigated data regarding socioeconomic and demographic characteristics, obstetric history, weight, and gestational age of the infant at birth. Maternal weight and breastfeeding status were obtained at 3, 6, 9 and 12 months postpartum at the mother’s home. A descriptive analysis of maternal weight retention according to the lactation status was performed. Multiple linear regression models evaluated the effect on exclusive breastfeeding and total breastfeeding duration on maternal weight retention at 6 and 12 months postpartum, considering potential confounders. Results: 512 and 490 mothers were evaluated at six months and at twelve months post-partum, and the mean weight retention was 1.79 (SD=5.52) and 1.69 (SD=6.69) kg, respectively. Regardless of the confounders, the mean postpartum weight reduction for each day of exclusive breastfeeding was 11 (CI95%= -0.019 to -0.003) and 16 grams (CI95%= -0.026 to -0.007) for 6 and 12 months, respectively. The total maternal breastfeeding duration had the same effect. Conclusions: longer periods of exclusive breastfeeding and total breastfeeding are associated with lower postpartum weight retention.

scholarly journals Association of Full Breastfeeding Duration with Postpartum Weight Retention in a Cohort of Predominantly Breastfeeding Women

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 938 ◽  
Author(s):  
Muna J. Tahir ◽  
Jacob L. Haapala ◽  
Laurie P. Foster ◽  
Katy M. Duncan ◽  
April M. Teague ◽  
...  
Keyword(s):  
Breastfeeding Duration ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Maternal Weight ◽  
Linear Mixed Effects ◽  
Prepregnancy Weight ◽  
Adjusted Means ◽  
Postpartum Weight ◽  
Healthy Growth ◽  
Pregnancy Weight

Full breastfeeding (FBF) is promoted as effective for losing pregnancy weight during the postpartum period. This study evaluated whether longer FBF is associated with lower maternal postpartum weight retention (PPWR) as compared to a shorter FBF duration. The MILK (Mothers and Infants Linked for Healthy Growth) study is an ongoing prospective cohort of 370 mother–infant dyads, all of whom fully breastfed their infants for at least 1 month. Breastfeeding status was subsequently self-reported by mothers at 3 and 6 months postpartum. Maternal PPWR was calculated as maternal weight measured at 1, 3, and 6 months postpartum minus maternal prepregnancy weight. Using linear mixed effects models, by 6 months postpartum, adjusted means ± standard errors for weight retention among mothers who fully breastfed for 1–3 (3.40 ± 1.16 kg), 3–6 (1.41 ± 0.69 kg), and ≥6 months (0.97 ± 0.32 kg) were estimated. Compared to mothers who reported FBF for 1–3 months, those who reported FBF for 3–6 months and ≥6 months both had lower PPWR over the period from 1 to 6 months postpartum (p = 0.04 and p < 0.01, respectively). However, PPWR from 3 to 6 months was not significantly different among those who reported FBF for 3–6 versus ≥6 months (p > 0.05). Interventions to promote FBF past 3 months may increase the likelihood of postpartum return to prepregnancy weight.

scholarly journals Maternal Obesity and Developmental Programming of Metabolic Disorders in Offspring: Evidence from Animal Models

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
M. Li ◽  
D. M. Sloboda ◽  
M. H. Vickers
Keyword(s):  
Animal Models ◽  
Early Life ◽  
Metabolic Disorders ◽  
Maternal Obesity ◽  
Maternal Weight ◽  
Critical Window ◽  
Obesity Epidemic ◽  
Obesity And Overweight ◽  
Increased Risk ◽  
Maternal Overnutrition

The incidence of obesity and overweight has reached epidemic proportions in the developed world as well as in those countries transitioning to first world economies, and this represents a major global health problem. Concern is rising over the rapid increases in childhood obesity and metabolic disease that will translate into later adult obesity. Although an obesogenic nutritional environment and increasingly sedentary lifestyle contribute to our risk of developing obesity, a growing body of evidence links early life nutritional adversity to the development of long-term metabolic disorders. In particular, the increasing prevalence of maternal obesity and excess maternal weight gain has been associated with a heightened risk of obesity development in offspring in addition to an increased risk of pregnancy-related complications. The mechanisms that link maternal obesity to obesity in offspring and the level of gene-environment interactions are not well understood, but the early life environment may represent a critical window for which intervention strategies could be developed to curb the current obesity epidemic. This paper will discuss the various animal models of maternal overnutrition and their importance in our understanding of the mechanisms underlying altered obesity risk in offspring.

scholarly journals The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health—Follow-Up of a Randomized Controlled Trial

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Stijn Mintjens ◽  
Mireille N. M. van Poppel ◽  
Henk Groen ◽  
Annemieke Hoek ◽  
Ben Willem Mol ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Maternal Obesity ◽  
Controlled Trial ◽  
Cardiometabolic Health ◽  
Control Group ◽  
Z Score ◽  
Infertile Women ◽  
Z Scores

Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3–6 years. We compared the child’s Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children’s age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.

scholarly journals Patterns of Women’s Postpartum Weight Retention and Its Associations with Maternal Obesity-Related Factors and Parity

2019 ◽  
Vol 16 (22) ◽  
pp. 4510 ◽  
Author(s):  
Tingting Sha ◽  
Gang Cheng ◽  
Chao Li ◽  
Xiao Gao ◽  
Ling Li ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Late Pregnancy ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Related Factors ◽  
Targeted Interventions ◽  
Growth Mixture ◽  
Class 1 ◽  
Multiparous Women ◽  
Postpartum Weight

Background: There is not much data on the effects of the timing of gestational weight gain (GWG), pre-pregnancy waist circumference (WC), pre-pregnancy body mass index (BMI), and parity, with postpartum weight retention (PPWR) trajectories. Methods: This study was based on a longitudinal cohort. Latent growth mixture models were applied to identify the latent trajectories of PPWR and test the effects of the predictors on distinct classes of PPWR trajectories. Results: Three PPWR trajectories were identified. About 2.8% (n = 26) of women were classified into Class 1, with an inverted U-shape trajectory; 6.6% (n = 61) were assigned to Class 2, with a rapid increase trajectory; 90.6% (n = 837) were classified into Class 3, with a significant decrease. Women who had a lower pre-pregnancy BMI (β = −0.279), higher pre-pregnancy WC (β = 0.111) and GWG (β = 0.723) were at a higher risk of retaining more weight at 1 month postpartum. Only GWG, especially GWG during late pregnancy, was associated with the rate of PPWR change. Parity was not associated with the changes in PPWR, while, compared to Class 1 trajectory, multiparous women were protected from having a Class 2 trajectory. Conclusions: Early targeted interventions should be taken to prevent women who were primiparous, and/or had a lower pre-pregnancy BMI and higher pre-pregnancy WC and GWG, from excessive PPWR.

scholarly journals 1309Breastfeeding and weight retention in women with Gestational Diabetes Mellitus (GDM): LINDA-Brasil Cohort

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Michele Drehmer ◽  
Kadhija Cherubini ◽  
Alvaro Vigo ◽  
Maria Inês Schmidt
Keyword(s):  
Post Partum ◽  
National Health System ◽  
Weight Retention ◽  
Maternal Weight ◽  
Relative Risks ◽  
Multicentre Cohort Study ◽  
Postpartum Weight ◽  
Telephone Calls ◽  
One Year ◽  
Pregnancy Weight

Abstract Background Breastfeeding seems to be inversely related to postpartum weight retention (PPWR), but this relationship is unclear in women with GDM. We aimed to describe the association between breastfeeding and PPWR at 1 year postpartum in women with GDM. Methods Multicentre cohort study of 524 women with GDM enrolled in prenatal clinics of the Brazilian National Health System and followed by telephone up to one year postpartum. Socio-demographics and pre-gestational weight were obtained during recruitment. Breastfeeding and post-partum maternal weight through telephone calls. PPWR was defined as 1-year postpartum weight minus pre-pregnancy weight and categorized as above and below the 80th sample percentile of retention. Breastfeeding was categorized as duration greater or less than 6 months. Adjusted Poisson regression was performed to assess relative risks (RR). Results Most women were 30 to 39 years old (50.6%), multiparous (71.0%), 39.5% completed high school, 60.1% were non-white (60.1%). Mean pre-gestational BMI was 30.42 (± 6.7) kg/m² and the mean weight gain during pregnancy was 9.5 (± 7.1) kg. After adjustments for previous variables, breastfeeding for 6 months or more reduced by 35% (RR 0.65; 95% CI 0.47; 0.90, p &lt; 0.01) the incidence of 1-year PPWR up to 80th percentile (≥7Kg) compared to breastfeeding less than 6 months. Conclusions Breastfeeding up to 6 months might be encouraged in women with GDM to help preventing higher levels of 1-year PPWR. Key messages Breastfeeding up to 6 months was associated with less PPWR at 1 year after delivery in women with GDM.

scholarly journals Effectiveness of a Group Educational Intervention – Prolact - In Primary Care to Promote Exclusive Breastfeeding. A Cluster Randomized Clinical Trial.

2021 ◽  
Author(s):  
María Jesús Santamaría-Martín ◽  
Susana Martín Iglesias ◽  
Christine Schwarz ◽  
Milagros Rico-Blázquez ◽  
Julián Alexander Portocarrero-Nuñez ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Educational Intervention ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
Control Group ◽  
Usual Practice ◽  
Factors Associated ◽  
Cluster Randomized

Abstract Background: The rates of exclusive breastfeeding at 6 months in Spain are far from the target recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care.Method: Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads (215 in the control group and 219 in the intervention group) who breastfed exclusively in the first 4 weeks of the infant's life and agreed to participate were included. The main outcome variable was exclusive breastfeeding at 6 months. Secondary variables were the type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the effectiveness, the difference in the proportions of dyads with exclusive breastfeeding at 6 months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6 months, a multilevel logistic regression model was fitted. All analyses were performed according to intention to treat.Results: The percentage of dyads with exclusive breastfeeding at 6 months was 22.4% in the intervention group and 8.8% in the control group. The PROLACT intervention obtained an RR of 2.53 (95% CI 1.54-4.15) and an NNT of 7 (95% CI 5-14). The factors associated with exclusive breastfeeding at 6 months were the PROLACT intervention, OR 3.51 (95% CI 1.55-7.93); age > 39 years, OR 2.79 (95% CI 1.02-7.6); previous breastfeeding experience, OR 2.61 (95% CI 1.29-5.29); monthly income/person > 833.33 €, OR 2.15 (95% CI: 0.996-4.65); planning to start work before the infant was 6 months old, OR 0.35 (0.19-0.63); and use of a pacifier, OR 0.58 (95% CI 0.30-1.11).Conclusions: The PROLACT group educational intervention in primary care is more effective than the usual practice for maintaining exclusive breastfeeding at 6 months.Trial registration: The trial was registered with ClinicalTrials.gov under code number NCT01869920 (03/06/2013).

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