Electronic‐based lifestyle interventions in overweight or obese perinatal women: a systematic review and meta‐analysis

Abstract

Electronic-based (e-based) lifestyle interventions provide potential and cost-effective delivery of remote interventions for overweight and obese perinatal women. To date, no meta-analysis has reported the efficacy of maternal and neonatal outcomes. Seven electronic databases were searched from inception up to July 13, 2016, including the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EMBASE, ProQuest Dissertations and Theses, PsycINFO, PubMed and Scopus. Among the 1,145 studies retrieved, 14 randomized controlled trials were selected among 17 publications. The Cochrane risk of bias tool was used to appraise the quality assessment. The meta-analyses demonstrated a significant result for limiting gestational weight gain, losing postnatal weight in 1-2 months, increasing self-reported moderate and vigorous physical activity and reducing caloric intake using diet-related software. Our review shows that an e-based lifestyle intervention is an acceptable approach. The findings reveal the variability in intervention methods and provide limited conclusive evidence. Thus, future studies should examine the efficacy and essential components as well as the various approaches using optimal portions of in-person and phone sessions. Further evaluations comparing the effectiveness of different e-based lifestyle intervention approaches toward activity-related and diet-related outcomes are necessary.

Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

“…Seven of the nine systematic reviews had performed meta‐analyses, while two reported only a narrative synthesis . No systematic review included exactly the same RCTs.…”

“…The definition of the postnatal period also varied between systematic reviews. Three defined this as up to 12 months after childbirth, one up to 18 months, and one up to 24 months . The remaining four systematic reviews stated that they included studies with postnatal women but did not define the postnatal period …”

“…Two of the systematic reviews placed no restrictions on the type of postnatal women they included from studies . However, three reviews included only women who either have overweight and/or have obesity, one systematic review only included women with a history of gestational diabetes, and one included only healthy women . Two did not report if they placed any restrictions on the type of postnatal women they would include …”

“…The scope of the included systematic reviews varied. Five of the reviews included studies that investigated the effectiveness of lifestyle interventions both during pregnancy and the postnatal period . However, as the review authors performed analyses for these populations separately, they were eligible for inclusion in this review of reviews.…”

“…However, as the review authors performed analyses for these populations separately, they were eligible for inclusion in this review of reviews. Two reviews focused exclusively on e‐health technology interventions . One review restricted its inclusion criteria to physical activity–only interventions while one focused on postnatal lifestyle interventions to prevent type 2 diabetes .…”