Effective strategies for weight loss in post‐partum women: a systematic review and meta‐analysis

Abstract

Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated with weight loss in post-partum women. MEDLINE, EMBASE, PubMed, CINAHL and four other databases were searched for lifestyle intervention studies (diet or exercise or both) in post-partum women (within 12 months of delivery) published up to July 2014. The primary outcome was weight loss. Subgroup analyses were conducted for self-monitoring, individual or group setting, intervention duration, intervention types, the use of technology as a support, and home- or centre-based interventions. From 12,673 studies, 46 studies were included in systematic review and 32 randomized controlled trials were eligible for meta-analysis (1,892 women, age 24-36 years). Studies with self-monitoring had significantly greater weight lost than those without (-4.61 kg [-7.08, -2.15] vs. -1.34 kg [-1.66, -1.02], P = 0.01 for subgroup differences). Diet and physical activity when combined were significantly more effective on weight loss compared with physical activity alone (-3.24 kg [-4.59, -1.90] vs. -1.63 kg [-2.16, -1.10], P < 0.001 for subgroup differences). Lifestyle interventions that use self-monitoring and take a combined diet-and-exercise approach have significantly greater weight loss in post-partum women.

Prevalence and Complications of Pregestational and Gestational Diabetes in Saudi Women: Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

“…Effective strategies should be implemented to reduce weight gain and obesity during pregnancy and in the postpartum period [33, 34]. …”

An evaluation of the impact of lifestyle interventions on body weight in postpartum women: A systematic review and meta‐analysis

“…However, the competing postpartum demands such as time pressure, tiredness or fatigue, newborn childcare, other family commitments, change in priorities, and the lack of social support can reduce a mother's ability to engage in lifestyle behavior change . Wide ranges of attrition rates in existing RCTs (0%–42%) suggest considerable barriers exist for postpartum mothers, but no RCTs in the current review focused on addressing these barriers to participation . Here, issues of hard to reach populations also apply including marginalized populations of low‐income countries.…”

The Effects of Exercise on Postpartum Weight Retention in Overweight and Obese Women

“…Choi et al [17] only included combined exercise and diet intervention in their review, however Elliott-Sale et al [15] and Nascimento et al [16] included four exercise-only studies; Bertz et al [18] was included in both reviews, Maturi et al [19] was excluded by Nascimento et al [16] as "the primary outcome was not available" and Dewey et al [20] and McIntyre et al [21] were not included by Elliott-Sale et al [15] as these studies were not applicable based on their search criteria, i.e., exercise interventions designed to manage maternal weight. Lim et al [22] published a systematic review and meta-analysis on effective strategies for weight loss in postpartum women and included 22 exercise only interventions. However, only two of their included studies were designed to influence body weight and were RCT's.…”