Effect of Lifestyle Interventions in Obese Pregnant Women on the Neurocognitive Development and Anthropometrics of Preschool Children

Braeken, Marijke; Bogaerts, An

doi:10.1159/000506690

Cited by 10 publications

(20 citation statements)

References 35 publications

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“…Compared to this cohort data, however, we observed a higher rate of children with underweight, and a slightly lower rate of children with obesity (extremely underweight: 1.4%, underweight: 3.8%, obese: 2.9%) [ 41 ]. The missing evidence of a reduction in the rate of childhood overweight at 2 and 3 years of age by antenatal lifestyle counselling in the GeliS study is in accordance with findings from other studies [ 19 , 20 , 42 , 43 , 44 ], and supported by findings from two recent meta-analyses [ 23 , 24 ]. Louise et al [ 24 ] performed an individual patient meta-analysis on randomised controlled trials (RCTs) including women with overweight or obesity on childhood outcomes at 3–5 years of age.…”

Section: Discussionsupporting

confidence: 88%

“…However, these comparable large-scale trials [ 19 , 43 ] have only considered women with overweight and/or obesity, whereas we also included women with normal weight. Furthermore, none of the aforementioned studies [ 19 , 20 , 42 , 43 , 44 ] were conducted alongside routine care.…”

Section: Discussionmentioning

confidence: 99%

“…However, the evidence for the long-term influence of maternal lifestyle interventions on offspring overweight and obesity risk is less clear [ 18 ], and the results of studies investigating their impact on child neurodevelopment are heterogeneous [ 19 , 20 , 21 , 22 ]. Two recent meta-analyses found that lifestyle interventions in pregnancy had no impact on either short- or long-term weight and growth outcomes in children [ 23 ], nor on early childhood obesity risk [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

Spies

Geyer

Raab

et al. 2022

JCM

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Maternal characteristics around pregnancy may influence obesity risk and neurodevelopment in children. To date, the effect of antenatal lifestyle interventions on long-term child development is unclear. The objective was to investigate the potential long-term effects of an antenatal lifestyle intervention programme conducted alongside routine care on child anthropometrics and neurodevelopment up to 3 years of age. Mother-child pairs from the cluster-randomised GeliS trial were followed up to 3 years of age. Data on child anthropometrics in both groups were collected from routine health examinations. Neurodevelopment was assessed via questionnaire. Of the 2286 study participants, 1644 mother-child pairs were included in the analysis. Children from the intervention group were less likely to score below the cut-off in Fine motor (p = 0.002), and more likely to have a score below the cut-off in Problem-solving (p < 0.001) compared to the control group at 3 years of age. Mean weight, height, head circumference, body mass index, and the respective z-scores and percentiles were comparable between the groups at 2 and 3 years of age. We found no evidence that the lifestyle intervention affected offspring development up to 3 years of age. Further innovative intervention approaches are required to improve child health in the long-term.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

Spies

Geyer

Raab

et al. 2022

JCM

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“…A total of seven primary trials [ 20 – 22 , 25 – 28 ] where follow-up of participants had occurred [ 29 – 32 ] were identified as eligible for inclusion in the IPDMA (Fig. 1 ), and the lead investigator approached to provide IPD.…”

Section: Resultsmentioning

confidence: 99%

The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials

Louise

Poprzeczny

Deussen

et al. 2021

BMC Med

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Background The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown. Methods We conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10+0 and 20+0 weeks and body mass index (BMI) ≥ 25 kg/m2 in early pregnancy were randomised to a diet and/or lifestyle intervention or continued standard antenatal care and in which longer-term maternal and child follow-up at 3–5 years of age had been undertaken. The primary childhood outcome was BMI z-score above the 90th percentile. Secondary childhood outcomes included skinfold thickness measurements and body circumferences, fat-free mass, dietary and physical activity patterns, blood pressure, and neurodevelopment. Results Seven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures. Conclusions In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions. Trial registration PROSPERO, CRD42016047165

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“…By contrast, LIFE-Moms [5] and other interventions [18] that effectively targeted and reduced excess gestational weight gain had no significant effects on child BMIz scores at 12 months. Prenatal intervention trials that targeted but had minimal to no effect on reducing gestational weight gain have also reported no effect on offspring BMIz at 6 months [24,25] 18 months [26], and at 3 and 7 years [27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months

et al. 2021

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Background/Objectives We previously reported results from a randomized trial showing that a behavioral intervention during pregnancy reduced excess gestational weight gain but did not impact maternal weight at 12 months. We now examine the longer-term effects of this prenatal intervention on maternal postpartum weight retention and toddler body-mass-index z scores (BMIz) over 36 months. Subjects/Methods Pregnant women (N = 264; 13.7 weeks’ gestation; 41.6% Hispanic) with overweight or obesity were randomized into usual care or prenatal intervention. Anthropometric assessments in mothers and toddlers occurred at baseline, 35 weeks’ gestation and after delivery at 6, 12, 18, 24, and 36 months. Results At 36 months, prenatal intervention vs. usual care had no significant effect on the proportion of participants who returned to their early pregnancy weight or below (33.3% vs. 39.5%; p = 0.12) and had no effect on the magnitude of weight retained (2.8 [0.8, 4.8] vs 3.0 kg [1.0, 4.9], respectively; mean difference = 0.14 [−3.0, 2.7]). There was also no statistically significant intervention vs. usual care effect on infant BMIz or skinfold changes over time; toddler BMIz increased by 1.4 [−1.7, 1.0] units in the intervention group and 1.6 [−1.2, 1.8] units in the usual care group from delivery to 36 months (difference = 0.16 [−0.32. 0.63]). The proportion of toddlers at risk for obesity at 36 months was similar in intervention and usual care groups (28/77 [36.4%] vs 30/80 [37.5%]; p = 0.77). Conclusions Compared with usual care, lifestyle intervention during pregnancy resulted in similar maternal and toddler anthropometric outcomes at 36-months postpartum in a diverse US sample of women with overweight and obesity. To sustain improved maternal weight management initiated during pregnancy, continued intervention during the postpartum years may be needed.

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Effect of Lifestyle Interventions in Obese Pregnant Women on the Neurocognitive Development and Anthropometrics of Preschool Children

Cited by 10 publications

References 35 publications

Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials

Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months

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