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      Diet or exercise, or both, for preventing excessive weight gain in pregnancy

      Author(s): 1 , 2 , 3 , 4
      Editor(s): Cochrane Pregnancy and Childbirth Group
      Publication date (Electronic):
      Journal: Cochrane Database of Systematic Reviews
      Publisher: Wiley

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          Abstract

          This is an update of a Cochrane review first published in 2012, Issue 4. Excessive weight gain during pregnancy is associated with poor maternal and neonatal outcomes including gestational diabetes, hypertension, caesarean section, macrosomia, and stillbirth. Diet or exercise interventions, or both, may reduce excessive gestational weight gain (GWG) and associated poor outcomes; however, evidence from the original review was inconclusive.

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          Gestational weight gain and child adiposity at age 3 years.

          Emily Oken, Elsie Taveras, Ken Kleinman … (2007)
          The purpose of this study was to examine the associations of gestational weight gain with child adiposity. Using multivariable regression, we studied associations of total gestational weight gain and weight gain according to 1990 Institute of Medicine guidelines with child outcomes among 1044 mother-child pairs in Project Viva. Greater weight gain was associated with higher child body mass index z-score (0.13 units per 5 kg [95% CI, 0.08, 0.19]), sum of subscapular and triceps skinfold thicknesses (0.26 mm [95% CI, 0.02, 0.51]), and systolic blood pressure (0.60 mm Hg [95% CI, 0.06, 1.13]). Compared with inadequate weight gain (0.17 units [95% CI, 0.01, 0.33]), women with adequate or excessive weight gain had children with higher body mass index z-scores (0.47 [95% CI, 0.37, 0.57] and 0.52 [95% CI, 0.44, 0.61], respectively) and risk of overweight (odds ratios, 3.77 [95% CI: 1.38, 10.27] and 4.35 [95% CI: 1.69, 11.24]). New recommendations for gestational weight gain may be required in this era of epidemic obesity.
          Article 0 comments Cited 185 times – based on 0 reviews     Review now
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            Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial.

            Isabelle Guelinckx, Roland Devlieger, Patrick Mullie … (2010)
            Maternal obesity and excessive gestational weight gain (GWG) are major short- and long-term risk factors for maternal and fetal complications. The objective was to study whether a lifestyle intervention based on a brochure or on active education can improve dietary habits, increase physical activity (PA), and reduce GWG in obese pregnant women. In this randomized controlled trial, 195 white, obese pregnant women [age: 29 + or - 4 y; body mass index (in kg/m(2)); 33.6 + or - 4.2] were randomly assigned into 3 groups: a group that received nutritional advice from a brochure, a group that received the brochure and lifestyle education by a nutritionist, and a control group. Nutritional habits were evaluated every trimester through 7-d food records. PA was evaluated with the Baecke questionnaire. Energy intake did not change during pregnancy and was comparable in all groups. Fat intake, specifically saturated fat intake, decreased and protein intake increased from the first to the third trimester in the passive and active groups compared with an opposite change in the control group. Calcium intake and vegetable consumption increased during pregnancy in all groups. PA decreased in all groups, especially in the third trimester. No significant differences in GWG and obstetrical or neonatal outcome could be observed between the groups. Both lifestyle interventions improved the nutritional habits of obese women during pregnancy. Neither PA nor GWG was affected.
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              Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial

              Jennifer M Walsh, Ciara McGowan, Rhona Mahony … (2012)
              Objective To determine if a low glycaemic index diet in pregnancy could reduce the incidence of macrosomia in an at risk group. Design Randomised controlled trial. Setting Maternity hospital in Dublin, Ireland. Participants 800 women without diabetes, all in their second pregnancy between January 2007 to January 2011, having previously delivered an infant weighing greater than 4 kg. Intervention Women were randomised to receive no dietary intervention or start on a low glycaemic index diet from early pregnancy. Main outcomes The primary outcome measure was difference in birth weight. The secondary outcome measure was difference in gestational weight gain. Results No significant difference was seen between the two groups in absolute birth weight, birthweight centile, or ponderal index. Significantly less gestational weight gain occurred in women in the intervention arm (12.2 v 13.7 kg; mean difference −1.3, 95% confidence interval −2.4 to −0.2; P=0.01). The rate of glucose intolerance was also lower in the intervention arm: 21% (67/320) compared with 28% (100/352) of controls had a fasting glucose of 5.1 mmol/L or greater or a 1 hour glucose challenge test result of greater than 7.8 mmol/L (P=0.02). Conclusion A low glycaemic index diet in pregnancy did not reduce the incidence of large for gestational age infants in a group at risk of fetal macrosomia. It did, however, have a significant positive effect on gestational weight gain and maternal glucose intolerance. Trial registration Current Controlled Trials ISRCTN54392969.
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                Author and article information

                Journal
                Title: Cochrane Database of Systematic Reviews
                Publisher: Wiley
                ISSN (Electronic): 14651858
                Publication date (Electronic): June 15 2015
                Affiliations
                [1 ]Faculty of Public Health, Khon Kaen University; Department of Nutrition; 123 Friendship Highway Khon Kaen Khon Kaen Thailand 40002
                [2 ]World Health Organization; Department of Reproductive Health and Research; Avenue Appia 20 Geneva Switzerland 1201
                [3 ]Khon Kaen University; Department of Obstetrics and Gynaecology, Faculty of Medicine; 123 Mitraparb Road Amphur Muang Khon Kaen Thailand 40002
                [4 ]Khon Kaen University; Department of Biostatistics and Demography, Faculty of Public Health; 123 Mitraparb Road Amphur Muang Khon Kaen Thailand 40002
                Article
                DOI: 10.1002/14651858.CD007145.pub3
                PubMed ID: 26068707
                SO-VID: 2fe11245-0a91-4c10-b5e3-1e7fd53c91de
                Copyright © © 2015
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