Lifestyle interventions to maternal weight loss after birth: a systematic review

Christiansen, Pernille Kjærgaard; Skjøth, Mette Maria; Rothmann, Mette Juel; Vinter, Christina Anne; Lamont, Ronald F.; Draborg, Eva

doi:10.1186/s13643-019-1186-2

Cited by 21 publications

(10 citation statements)

References 32 publications

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“…Although mothers face many barriers to continued weight management during the postpartum period, a variety of interventions, including internet-based lifestyle interventions, can effectively promote postpartum weight loss in diverse mothers [15][16][17]. In the current trial, postpartum weight gain appeared most pronounced after 12-months postpartum, suggesting a possibility that interventions could resume later in the postpartum year, after the initial dramatic changes of having a newborn have subsided.…”

Section: Discussionmentioning

confidence: 79%

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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Section: Discussionmentioning

confidence: 79%

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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“…Current recommendations emphasize lifestyle modification for all but the highest-risk postpartum patients. Continued research on behavioral approaches to CVD risk reduction after APOs-including the most effective means to support postpartum weight loss 55 and the effects of breastfeeding on maternal cardiometabolic health 56 -is essential to inform practice.…”

Section: Discussionmentioning

confidence: 99%

Primary Care–Based Cardiovascular Disease Risk Management After Adverse Pregnancy Outcomes: a Narrative Review

et al. 2022

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Several common adverse pregnancy outcomes can reveal subclinical or latent cardiovascular disease (CVD) risk, transiently exposed through the physiologic stress of pregnancy. The year after pregnancy may be a singular opportunity to identify and initiate treatment for CVD risk, even before the onset of traditional CVD risk factors. However, clinical guidance regarding CVD risk management after adverse pregnancy outcomes is lacking. We therefore conducted a systematic review of US clinical practice guidelines and professional society recommendations to inform primary care-based CVD risk management after adverse pregnancy outcomes. We identified 13 relevant publications. While most recommendations were based on limited or weak evidence, we identified several areas of consensus. First, individuals with an adverse pregnancy outcome associated with future CVD are likely to benefit from CVD risk assessment-accompanied by education, counseling, and support for lifestyle modification-beginning within the first postpartum year. Second, among clinicians, clear and consistent documentation about adverse pregnancy outcomes and recommended follow-up is important to coordinate care after pregnancy. In addition, patients need to be informed about their pregnancy complications and associated CVD risks, so that they can make informed health care and lifestyle decisions. Finally, in general, CVD prevention in the year after an adverse pregnancy outcome focuses on lifestyle modification, reserving pharmacotherapy for the highest-risk patients and those with traditional CVD risk factors. While postpartum lifestyle interventions show promise for reducing CVD risk after adverse pregnancy outcomes, continued research to determine the optimal content, timing, and long-term effects of such interventions is needed.

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“…The postpartum and interpregnancy periods are windows of opportunity to optimize weight and health before a subsequent pregnancy [ 43 , 44 ] and interventions aimed to promote adequate interpregnancy intervals have the potential to reduce the risk of adverse outcomes such as infant and child mortality and low birth weight as well as benefit maternal health. Second, our results highlight the urgent need to implement interventions aiming to prevent excessive gestational weight gain and postpartum weight retention, such as nutrition and physical activity advice and breastfeeding support [ 45 ], and to include these as core components of postpartum and interpregnancy care. After pregnancy, women should be encouraged and supported to reach their pre-gestational weight by 6 - 12 months postpartum and ultimately to achieve and maintain a healthy BMI [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Age at childbirth and change in BMI across the life-course: evidence from the INCAP Longitudinal Study

Mazariegos

Varghese

Kroker-Lobos

et al. 2022

BMC Pregnancy Childbirth

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Background Parity has been associated with both short- and long-term weight gain in women. However, it is not clear if timing of parity across the reproductive age has different associations with BMI. Methods To prospectively assess the association between age at childbirth and maternal change in BMI, we analyzed data from the ongoing INCAP Longitudinal Study, which started in 1969 in four villages in Guatemala. Cohort women (n=778) provided information on reproductive history and anthropometric measures were measured in 1988-89 (adolescence, 15 to 25y), 2002-04 (early adulthood, 26 to 36y) and 2015-17 (mid adulthood, 37 to 55y). We evaluated the associations of number of live births in the period preceding each study wave (1969-77 to 1988-89, 1988-89 to 2002-04 and 2002-04 to 2015-17) with BMI change in the same period using multivariable linear regression models. Results Number of live births between 1988 and 89 and 2002-04 was positively associated with increased BMI, while there was not an association between number of live births and BMI in the other intervals. Women who had one, two, or three or more children between 1988 and 89 and 2002-04 had 0.90 (kg/m2, 95% CI: -0.55, 2.35), 2.39 (kg/m2, 95% CI: 1.09, 3.70) and 2.54 (kg/m2, 95% CI: 1.26, 3.82) higher BMI, respectively, than women who did not give birth in the same period. Conclusions Our findings suggest that women who had three or more children during early adulthood gained more weight compared to women who had no children in the same period. In contrast, women who had children earlier or later in their reproductive lives did not gain additional weight compared to those who did not have children during that period. Childbirth may have different associations with BMI based on the mother’s age.

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Lifestyle interventions to maternal weight loss after birth: a systematic review

Cited by 21 publications

References 32 publications

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

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

Primary Care–Based Cardiovascular Disease Risk Management After Adverse Pregnancy Outcomes: a Narrative Review

Age at childbirth and change in BMI across the life-course: evidence from the INCAP Longitudinal Study

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