Table 2

A summary of the studies that met the criteria of the systematic review on lifestyle interventions in overweight and obese pregnant women: randomised trials

Author (year)

Ethnic group/Country

Participant/setting

Sample size

Intervention

Outcome measure(s)

Conclusion


Polley et al. (2002) [32]

31% black and 61% white/USA

Recruited before 20 weeks of pregnancy (normal BMI > 19.5 to 24.9; overweight BMI ≥ 25 to < 30 kg/m2)/Hospital based

120, including 49 overweight

59 in control arm; 61 in intervention arm

Exercise and nutrition information (oral and newsletter) Personalised graphs and behavioural counselling.

Gestational weight gain; gestational diabetes; Caesarean section; birthweight

No statistically significant reduction in gestational weight, prevalence of gestational diabetes, Caesarean section, or large for gestational age baby

Hui et al. (2006) [33]

Predominantly Caucasian/Canada

Less than 26 weeks pregnant (community based and antenatal clinics). All BMI categories. Mean BMI of non-intervention arm = 25.7 (SD = 6.3) and for intervention arm = 23.4(SD = 3.9)

45

21 in non-intervention arm; 24 in intervention arm

Physical exercise (group-sessions home-based exercise)

Individualized nutrition plans

Gestational weight gain

No statistically significant reduction in gestational weight gain

Wolff et al., 2008 [30]

100% Caucasian/Denmark

Obese (BMI ≥ 30 kg/m2) women enrolled at 15 weeks' gestation

50 analysed

23 in control arm; 27 in intervention arm

Intensive intervention with 10 one-hour visits with a dietician at each antenatal visit, dietary guidance provided

Gestational weight gain; gestational diabetes; Caesarean section; birthweight

Statistically significant reduction in gestational weight gain, no statistically significant reduction in prevalence of gestational diabetes or Caesarean section, or birthweight

Jeffries et al., 2009 [28]

> 90% Caucasian/Australia

Women at or below 14 weeks' gestation. All BMI categories included

286

138 in control arm; 148 in intervention arm

Personalised weight measurement card (based on Institute of Medicine guidelines). Control had only single measurement at enrolment

Gestational weight gain

No statistically significant reduction in gestational weight gain.

Ong et al., 2009 [42]

Predominantly Caucasian/Australia

Pregnant obese women recruited at 18 weeks' gestation

12

six in control arm; six in intervention arm

Personalised 10 weeks of home-based supervised exercise (three sessions per week)

Maternal aerobic fitness and gestational diabetes

No statistically significant difference in aerobic fitness or gestational diabetes

Barakat et al., 2011 [41]

100% Caucasian/Spain

All BMI categories

160

80 in control arm; 80 in intervention arm

Three group-based sessions per week, light resistance and toning exercise from the second trimester

Gestational weight gain and birthweight

No statistically significant difference in gestational weight gain and birth weight. Exercise intervention might attenuate adverse consequences of maternal BMI on newborn birth size

Asbee et al., 2009 [27]

26% African American/USA

Pregnant women recruited before 16 weeks' gestation. All BMI categories except those of BMI > 40 kg/m2

100

43 in control arm; 53 in intervention arm

One session of dietetic counselling and activity

Gestational weight gain; pregnancy outcome

Statistically significant reduction in gestational weight gain. No effect on pregnancy outcome

Thornton et al., 2009 [29]

41% African American/USA

Obese pregnant women (BMI ≥ 30 kg/m2) recruited between 12 and 28 weeks' gestation

257 randomised.

25 lost to follow up. 116 in control arm; 116 in intervention arm

Nutritional regime for gestational diabetes

Gestational weight gain; gestational diabetes; Caesarean section; pregnancy outcome

Statistically significant reduction in gestational weight gain, no statistically significant reduction in prevalence of gestational diabetes, Caesarean section or birthweight

Guelinckx et al., 2010 [26]

100% Caucasian/Belgium

Obese (BMI > 30 kg/m2) women enrolled at 15 weeks' gestation.

195 randomised

85 analysed

65 in control arm; 65 in passive arm, 65 in intervention arm

Three arms: group sessions with a dietician; written brochures; and standard care

Dietary and physical activity guidance provided by dietician and in written brochures

Nutritional habits; gestational weight gain; gestational diabetes; Caesarean section; birthweight

Improved nutritional habits; no statistically significant reduction in gestational weight gain, prevalence of gestational diabetes, Caesarean section or birthweight.

Phelan et al., 2011 [34]

67% White/USA

Pregnant women BMI between 19.8 and 40 kg/m2 recruited between 10 and 16 weeks' gestation

401 randomised.

201 in non-intervention arm; 200 in intervention arm

Exercise and nutrition information (oral and newsletter) Personalised graphs and behavioural counselling

Gestational weight gain; gestational diabetes; Caesarean section; pregnancy outcome

Significant reduction in gestational weight gain; no statistically significant reduction in prevalence of gestational diabetes, Caesarean section or birthweight

Quinlivan et al., 2011 [59]

73% white, 19% Asian/Australia

Pregnant women: overweight (BMI 25 to 29.9 kg/m2) and obese (BMI ≥ 30 kg/m2)

132 randomised.

65 in non-intervention arm; 67 in intervention arm

Attended a study- specific antenatal clinic providing continuity of care, weighing on arrival, brief dietary intervention by food technologist and psychological assessment and intervention if indicated

Gestational weight gain; gestational diabetes; birthweight

Statistically significant reduction in gestational weight gain and prevalence of gestational weight gain. No statistically significant reduction in birthweight.

Luoto et al., 2011 [43]

Predominantly white/Finland

Pregnant women at risk of gestational diabetes. All BMI ranges

399 cluster randomised.

219 in non-intervention arm; 180 in intervention arm

Attended a study-specific individual antenatal lifestyle counselling clinic including group exercise

Gestational diabetes; gestational weight gain; birthweight

Statistically significant reduction in birthweight and macrosomia but no statistically significant difference in gestational diabetes

Nascimento et al., 2011 [44]

Predominantly white/Brazil

Pregnant women of all BMI categories

82 randomised.

42 in non-intervention arm; 40 in intervention arm

Attended a group-based exercise under supervision and received a home exercise counselling

Gestational weight gain; raised blood pressure; perinatal outcome

No statistically significant difference in gestational weight gain in terms of gestational weight gain, raised blood pressure or perinatal outcome


BMI: body mass index; SD: standard deviation

Oteng-Ntim et al. BMC Medicine 2012 10:47   doi:10.1186/1741-7015-10-47

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