The Effect of a General Healthy Lifestyle Intervention Delivered Around Pregnancy on Gestational Weight Gain and Infant
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The Effect of a General Healthy Lifestyle Intervention Delivered Around Pregnancy on Gestational Weight Gain and Infant Growth William J. Heerman1 · Lauren R. Samuels2 · Lauren Barr3 · Laura E. Burgess1 · Katherine E. Hartmann4 · Shari L. Barkin1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives A life-course perspective emphasizes healthy behaviors before, during, and after pregnancy to support a multigenerational risk reduction in obesity for mothers and infants. Optimal timing, content, and dose of such interventions is not well defined. Methods We conducted a nested cohort within a randomized trial to evaluate whether a healthy lifestyle intervention around pregnancy led to a “spill-over effect,” including a healthier rate (kg/week) of maternal gestational weight gain, and infant growth during the first year. Study enrollment began in 2012, follow-up data collection completed in 2018, and the data were analyzed in 2019. The intervention focused on healthy maternal diet and physical activity but not pregnancy weight or infant feeding. Outcome data were abstracted from electronic medical records. Results Of the 165 women who became pregnant, 114 enrolled in the nested cohort. The average pre-pregnancy BMI was 29.6 (SD 5.1) kg/m2. Mixed effects models suggested clinically insignificant differences in both the rate of gestational weight gain (-0.02 kg/week; 95% CI -0.09, 0.06) and the rate of infant growth (difference at 1 year: -0.002 kg/cm; 95% CI -0.009, 0.005). Conclusions for Practice A behavioral intervention that focused on overall maternal health delivered in the time around pregnancy did not result in a “spill-over effect” on healthy gestational weight gain or healthy infant growth during the first year of life. Trial Registration This study is registered at www.clinicaltrials.gov NCT01316653. Keywords Obesity · Behavioral intervention · Pregnancy · Gestational weight gain · Infancy
Significance
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-02998-0) contains supplementary material, which is available to authorized users. * William J. Heerman [email protected] 1
Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 2nd Floor, Nashville, TN 37212, USA
2
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
3
Vanderbilt University Medical School, Nashville, TN, USA
4
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
What is already known on this subject? Excess weight gain during pregnancy and postpartum weight retention contribute to obesity development in women during childbearing years and disproportionately affect ethnic minority and low-income populations. Previous interventions to support healthy gestational weight gain have met with limited success, and enrolling women during the first trimester is challenging. What this study adds? A general healthy lifestyle
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