Effects of Antenatal Lifestyle Interventions in Pregnant Women with Normal Body Mass Index
Abstract
Background: We aimed to explore the effect of lifestyle interventions on improving lifestyle behaviors on gestational weight gain in pregnant women with normal body mass index (BMI).
Methods: The study was conducted in Maternal and Child Health Hospital of Hubei Province (Wuhan, China) between June 2020 and April 2022. A total of 355 pregnant women (<12 weeks of pregnancy) were enrolled and finally completed the program. Participants were divided into the intervention and control groups. The intervention group received an individualized lifestyle intervention focusing on healthy lifestyle, like diet, exercise, and weight monitoring as four sessions at 16–18, 20–24, 28-30 and 34 weeks’ gestation. Participants in the control group received routine antenatal care. The weight of both group was recorded from pregnancy until 6-8 weeks postpartum.
Results: The participants in the intervention group with normal pre-pregnancy BMI (n = 178) had lower GWG, excessive GWG, hypertension, and neonate birth weight compared to the control group (n = 177, P< 0.01). There were no statistically significant differences in the occurrence of gestational diabetes, premature labor, delivery mode, preterm birth, small for gestational age, macrosomia, number of neonates referred to the NICU, and postpartum weight retention.
Conclusion: Even though lifestyle intervention in pregnant women with normal BMI has a relatively limited effect, attention should still be paid to reasonable weight gain during pregnancy and the potential long-term impact of the intervention remains to be assessed.
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5. O'Brien C M, Grivell R M, Dodd J M (2016). Systematic review of antenatal dietary and lifestyle interventions in women with a normal body mass index. Acta Obstet Gynecol Scand, 95(3):259-269.
6. Choi H, Lim J Y, Lim N K, et al (2022). Impact of pre-pregnancy body mass index and gestational weight gain on the risk of maternal and infant pregnancy complica-tions in Korean women. Int J Obes (Lond), 46(1):59-67.
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8. Goletzke J, De Haene J, Stotland N E, et al (2021). Effect of a Low-Glycemic Load Diet Intervention on Maternal and Pregnancy Outcomes in Obese Pregnant Women. Nu-trients, 13(3).
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10. Cambos S, Rigalleau V, Blanco L (2018). A Medically Supervised Pregnancy Exercise In-tervention in Obese Women: A Random-ized Controlled Trial. Obstet Gynecol, 131(3):599.
11. Flannery C, Fredrix M, Olander E K, et al (2019). Effectiveness of physical activity in-terventions for overweight and obesity dur-ing pregnancy: a systematic review of the content of behaviour change interventions. Int J Behav Nutr Phys Act, 16(1):97.
12. Hui A L, Back L, Ludwig S, et al (2014). Ef-fects of lifestyle intervention on dietary in-take, physical activity level, and gestational weight gain in pregnant women with differ-ent pre-pregnancy Body Mass Index in a randomized control trial. BMC Pregnancy Childbirth, 14:331.
13. Muktabhant B, Lawrie T A, Lumbiganon P, et al (2015). Diet or exercise, or both, for preventing excessive weight gain in preg-nancy. Cochrane Database Syst Rev, (6):D7145.
14. [No authors listed] (2017). Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of indi-vidual participant data from randomised tri-als. BMJ, 358:j3119.
15. Beauchesne A R, Cara K C, Chen J, et al (2021). Effectiveness of multimodal nutri-tion interventions during pregnancy to achieve 2009 Institute of Medicine gesta-tional weight gain guidelines: a systematic review and meta-analysis. Ann Med, 53(1):1179-1197.
16. Fair F, Soltani H (2021). A meta-review of systematic reviews of lifestyle interventions for reducing gestational weight gain in women with overweight or obesity. Obes Rev, 22(5):e13199.
17. Cantor AG, Jungbauer RM, McDonagh M, et al (2021). Counseling and Behavioral In-terventions for Healthy Weight and Weight Gain in Pregnancy: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 325(20):2094-2109.
18. Krebs F, Lorenz L, Nawabi F, et al (2022). Effectiveness of a Brief Lifestyle Interven-tion in the Prenatal Care Setting to Prevent Excessive Gestational Weight Gain and Im-prove Maternal and Infant Health Out-comes. Int J Environ Res Public Health, 19(10).
19. Sun Y, Zhao H (2016). The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chi-nese overweight and obese women: A qua-si-experimental study. Appl Nurs Res, 30:125-130.
20. [No authors listed] (2015). ACOG Commit-tee Opinion No. 650: Physical Activity and Exercise during Pregnancy and the Postpar-tum Period. Obstet Gynecol, 126(6):e135-e142.
21. Farpour-Lambert NJ, Ells LJ, Martinez DTB, et al (2018). Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne), 9:546.
22. Frankenthal D, Hirsh-Yechezkel G, Boyko V, et al (2019). The effect of body mass in-dex (BMI) and gestational weight gain on adverse obstetrical outcomes in pregnancies following assisted reproductive technology as compared to spontaneously conceived pregnancies. Obes Res Clin Pract, 13(2):150-155.
23. Allen R, Rogozinska E, Sivarajasingam P, et al (2014). Effect of diet- and lifestyle-based metabolic risk-modifying interventions on preeclampsia: a meta-analysis. Acta Obstet Gynecol Scand, 93(10):973-985.
24. Redman LM, Drews KL, Klein S, et al (2021). Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium. Diabetes Res Clin Pract, 171:108549.
25. Kunath J, Gunther J, Rauh K, et al (2019). Effects of a lifestyle intervention during pregnancy to prevent excessive gestational weight gain in routine care - the cluster-randomised GeliS trial. BMC Med, 17(1):5.
26. Li N, Liu E, Guo J, et al (2013). Maternal prepregnancy body mass index and gesta-tional weight gain on pregnancy outcomes. PLoS One, 8(12):e82310.
27. Shine S, Derseh B, Alemayehu B, et al (2020). Magnitude and associated factors of husband involvement on antenatal care fol-low up in Debre Berhan town, Ethiopia 2016: a cross sectional study. BMC Pregnancy Childbirth, 20(1):567.
28. Slomski A (2020). Telehealth Reduces Ex-cess Weight Gain in Pregnancy. JAMA, 324(4):327.
2. Jin Y, Dai X, Wang N, et al (2021). Clinical Observation of Effects of Prepregnancy Body Mass Index and Weight Gain during Pregnancy on Neonatal Weight and Delivery Outcome. Evid Based Complement Alternat Med, 2021:8323189.
3. to I O M U, Guidelines R I P W (2009). Weight Gain during Pregnancy: Reexamin-ing the Guidelines. Washington (DC): Na-tional Academies Press (US).
4. Guan P, Tang F, Sun G, et al (2019). Effect of maternal weight gain according to the In-stitute of Medicine recommendations on pregnancy outcomes in a Chinese popula-tion. J Int Med Res, 47(9):4397-4412.
5. O'Brien C M, Grivell R M, Dodd J M (2016). Systematic review of antenatal dietary and lifestyle interventions in women with a normal body mass index. Acta Obstet Gynecol Scand, 95(3):259-269.
6. Choi H, Lim J Y, Lim N K, et al (2022). Impact of pre-pregnancy body mass index and gestational weight gain on the risk of maternal and infant pregnancy complica-tions in Korean women. Int J Obes (Lond), 46(1):59-67.
7. Lackovic M, Filimonovic D, Mihajlovic S, et al (2020). The Influence of Increased Pre-pregnancy Body Mass Index and Excessive Gestational Weight Gain on Pregnancy Course and Fetal and Maternal Perinatal Outcomes. Healthcare (Basel), 8(4).
8. Goletzke J, De Haene J, Stotland N E, et al (2021). Effect of a Low-Glycemic Load Diet Intervention on Maternal and Pregnancy Outcomes in Obese Pregnant Women. Nu-trients, 13(3).
9. Renault K M, Carlsen E M, Haedersdal S, et al (2017). Impact of lifestyle intervention for obese women during pregnancy on mater-nal metabolic and inflammatory markers. Int J Obes (Lond), 41(4):598-605.
10. Cambos S, Rigalleau V, Blanco L (2018). A Medically Supervised Pregnancy Exercise In-tervention in Obese Women: A Random-ized Controlled Trial. Obstet Gynecol, 131(3):599.
11. Flannery C, Fredrix M, Olander E K, et al (2019). Effectiveness of physical activity in-terventions for overweight and obesity dur-ing pregnancy: a systematic review of the content of behaviour change interventions. Int J Behav Nutr Phys Act, 16(1):97.
12. Hui A L, Back L, Ludwig S, et al (2014). Ef-fects of lifestyle intervention on dietary in-take, physical activity level, and gestational weight gain in pregnant women with differ-ent pre-pregnancy Body Mass Index in a randomized control trial. BMC Pregnancy Childbirth, 14:331.
13. Muktabhant B, Lawrie T A, Lumbiganon P, et al (2015). Diet or exercise, or both, for preventing excessive weight gain in preg-nancy. Cochrane Database Syst Rev, (6):D7145.
14. [No authors listed] (2017). Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of indi-vidual participant data from randomised tri-als. BMJ, 358:j3119.
15. Beauchesne A R, Cara K C, Chen J, et al (2021). Effectiveness of multimodal nutri-tion interventions during pregnancy to achieve 2009 Institute of Medicine gesta-tional weight gain guidelines: a systematic review and meta-analysis. Ann Med, 53(1):1179-1197.
16. Fair F, Soltani H (2021). A meta-review of systematic reviews of lifestyle interventions for reducing gestational weight gain in women with overweight or obesity. Obes Rev, 22(5):e13199.
17. Cantor AG, Jungbauer RM, McDonagh M, et al (2021). Counseling and Behavioral In-terventions for Healthy Weight and Weight Gain in Pregnancy: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 325(20):2094-2109.
18. Krebs F, Lorenz L, Nawabi F, et al (2022). Effectiveness of a Brief Lifestyle Interven-tion in the Prenatal Care Setting to Prevent Excessive Gestational Weight Gain and Im-prove Maternal and Infant Health Out-comes. Int J Environ Res Public Health, 19(10).
19. Sun Y, Zhao H (2016). The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chi-nese overweight and obese women: A qua-si-experimental study. Appl Nurs Res, 30:125-130.
20. [No authors listed] (2015). ACOG Commit-tee Opinion No. 650: Physical Activity and Exercise during Pregnancy and the Postpar-tum Period. Obstet Gynecol, 126(6):e135-e142.
21. Farpour-Lambert NJ, Ells LJ, Martinez DTB, et al (2018). Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne), 9:546.
22. Frankenthal D, Hirsh-Yechezkel G, Boyko V, et al (2019). The effect of body mass in-dex (BMI) and gestational weight gain on adverse obstetrical outcomes in pregnancies following assisted reproductive technology as compared to spontaneously conceived pregnancies. Obes Res Clin Pract, 13(2):150-155.
23. Allen R, Rogozinska E, Sivarajasingam P, et al (2014). Effect of diet- and lifestyle-based metabolic risk-modifying interventions on preeclampsia: a meta-analysis. Acta Obstet Gynecol Scand, 93(10):973-985.
24. Redman LM, Drews KL, Klein S, et al (2021). Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium. Diabetes Res Clin Pract, 171:108549.
25. Kunath J, Gunther J, Rauh K, et al (2019). Effects of a lifestyle intervention during pregnancy to prevent excessive gestational weight gain in routine care - the cluster-randomised GeliS trial. BMC Med, 17(1):5.
26. Li N, Liu E, Guo J, et al (2013). Maternal prepregnancy body mass index and gesta-tional weight gain on pregnancy outcomes. PLoS One, 8(12):e82310.
27. Shine S, Derseh B, Alemayehu B, et al (2020). Magnitude and associated factors of husband involvement on antenatal care fol-low up in Debre Berhan town, Ethiopia 2016: a cross sectional study. BMC Pregnancy Childbirth, 20(1):567.
28. Slomski A (2020). Telehealth Reduces Ex-cess Weight Gain in Pregnancy. JAMA, 324(4):327.
| Files | ||
| Issue | Vol 52 No 2 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i2.11891 | |
| Keywords | ||
| GWG (Gestational weight gain) BMI (Body mass index) PWR (Postpartum weight retention) | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Yang H, Zhao Y, Tu J, Chang Y, Xiao C. Effects of Antenatal Lifestyle Interventions in Pregnant Women with Normal Body Mass Index. Iran J Public Health. 2023;52(2):381-388.
