Prenatal lifestyle interventions can decrease gestational weight gain

Key takeaways:

• Interventions delivered by an allied health professional led to a greater gestational weight gain decrease.
• Individual delivery formats and moderate session amounts led to more gestational weight gain decreases.

Prenatal lifestyle interventions delivered by an allied health professional, with individual delivery formats and a moderate number of sessions, decreased gestational weight gain, according to data published in JAMA Network Open.

“In a secondary analysis of our 2022 systematic review reporting on the association of lifestyle interventions with efficacy in optimizing gestational weight gain, this meta-analysis aims to elucidate and describe components of antenatal lifestyle interventions that are associated with optimized gestational weight gain within published randomized clinical trials, providing critical and pragmatic information for implementations of trials in antenatal care settings,” Cheryce L. Harrison, BBNSc, PhD, senior research fellow and co-lead of the Healthy Lifestyle Stream at the Monash Centre for Health Research and Implementation at the School of Public Health and Preventive Medicine, Monash University in Melbourne, Australia, and colleagues wrote.

Harrison and colleagues searched the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, MEDLINE and Embase from January 1990 to May 2020. Researchers identified 99 randomized clinical trials of 34,546 pregnant women that examined the efficacy of antenatal lifestyle interventions in optimizing gestational weight gain.

Researchers assessed characteristics of antenatal lifestyle interventions including domains such as theoretical framework, material, procedure, facilitator, delivery format, mode, location, gestational age at commencement, number of sessions, duration, tailoring, attrition and adherence.

Interventions delivered by an allied health professional were associated with a greater gestational weight gain decrease compared with interventions delivered by other facilitators (mean difference, –1.36 kg; 95% CI, –1.71 to –1.02; P < .001). Dietary interventions with an individual delivery format (mean difference, –3.91 kg; 95% CI, –5.82 to –2.01; P = .002) and a moderate number of sessions (mean difference, –4.35 kg; 95% CI, –5.8 to –2.89; P < .001) were associated with greatest gestational weight gain decreases.

In addition, researchers observed associations with reduced gestational weight gain among physical activity and mixed behavioral interventions.

“These findings suggest that future pragmatic research should focus on testing and evaluating components to inform implementation in varied antenatal care settings, including those with limited resources, to optimize population benefit for pregnant individuals and the next generation,” the researchers wrote.