Do Lifestyle Interventions in Pregnant Women with Overweight or Obesity Have an Effect on Neonatal Adiposity? A Systematic Review with Meta-Analysis

Abstract

Excessive body fat at birth is a risk factor for the development of childhood obesity. The aim of the present systematic review with meta-analysis was to evaluate the effect of lifestyle interventions in pregnant women with overweight or obesity on neonatal adiposity. The PubMed, Embase, Web of Science, Scopus, and Virtual Health Library databases were used as information sources. Original articles from randomized clinical trials of lifestyle intervention studies on pregnant women with excessive body weight and the effect on neonatal adiposity were considered eligible. The risk of bias was assessed using Cochrane criteria. The meta-analysis was calculated using the inverse variance for continuous data expressed as mean difference (MD), using the random effect model with a 95% confidence interval (CI). The outcomes were submitted to the GRADE evaluation. Of 2877 studies, four were included in the qualitative and quantitative synthesis (n = 1494). All studies were conducted in developed countries, with three including pregnant women with overweight or obesity, and one only pregnant women with obesity. The interventions had no effect on neonatal adiposity (Heterogeneity = 56%, MD = −0.21, CI = (−0.92, 0.50)) with low confidence in the evidence, according to GRADE. Studies are needed in low- and medium-developed countries with different ethnic-racial populations. PROSPERO (CRD42020152489).

The effects of a lifestyle intervention (the HealthyMoms app) during pregnancy on infant body composition: Secondary outcome analysis from a randomized controlled trial

“…To conclude, current evidence from lifestyle interventions initiated in pregnancy, including this analysis from the HealthyMoms trial, indicates that even though improvements of maternal lifestyle factors such as healthier eating and reduced GWG are observed, no effects on foetal overgrowth and adiposity have been shown. This was also the conclusion of a recent meta‐analysis using data on existing randomized controlled trials with infant body fatness as outcome 22 as well as several individual studies, 43,44 and reviews that compiled evidence from trials with infant outcomes related to birthweight 45,46 . This may appear discouraging; however, evidence is still scarce making it relevant to call for further studies.…”

“…In that aspect, pregnancy has been proposed as a key period for prevention of childhood obesity through improving maternal lifestyle factors (e.g., diet and physical activity) to reduce excessive GWG 11,12,19 . Consequently, and also due to the increased prevalence of maternal obesity globally, 20 an interest in lifestyle interventions (i.e., focusing on diet and physical activity) targeting pregnant women to promote healthy GWG with outcomes also in their offspring such as infant adiposity has emerged 21,22 . Compared to measurements of weight alone, assessment of body composition provides more detailed information on foetal growth, and it has been hypothesized that fat‐ and fat‐free mass mediate the link between foetal nutrition experience and later disease 23 .…”

“… 11 , 12 , 19 Consequently, and also due to the increased prevalence of maternal obesity globally, 20 an interest in lifestyle interventions (i.e., focusing on diet and physical activity) targeting pregnant women to promote healthy GWG with outcomes also in their offspring such as infant adiposity has emerged. 21 , 22 Compared to measurements of weight alone, assessment of body composition provides more detailed information on foetal growth, and it has been hypothesized that fat‐ and fat‐free mass mediate the link between foetal nutrition experience and later disease. 23 In that aspect, air‐displacement plethysmography (Pea Pod) has been described as an accurate method with high reliability to assess infant body fatness.…”

Nutritional, Anthropometric and Sociodemographic Factors Affecting Fatty Acids Profile of Pregnant Women’s Serum at Labour—Chemometric Studies

“…Preconception maternal excessive body weight is associated with greater adiposity in children with detrimental consequences in adulthood [ 38 ]. Total weight gain during pregnancy is strongly associated with birth-size parameters.…”

New Developments, Challenges and Open Questions in Diagnosis and Treatment of Gestational Diabetes Mellitus

“…Therefore, a more detailed investigation of pathophysiological alterations associated with an exceeding maternal BMI will be necessary. Since lifestyle interventions [ 23 ], as well as pharmacotherapy with metformin [ 24 , 25 ], failed to improve pregnancy outcomes in obese pregnancies without diabetes, future research should focus on strategies optimising preconception care and pregestational weight in obese women before conception.…”