One‐year postpartum outcomes following a weight management intervention in pregnant women with obesity

Abstract

Objective This analysis focuses on 1-year maternal and infant follow-up of a randomized trial that tested a weight management intervention conducted during pregnancy. Methods We randomly assigned 114 women with obesity (mean BMI 36.7 kg/m2) at a mean of 15 weeks’ gestation to a weight management intervention or usual care control condition. The intervention ended at delivery and resulted in less gestational weight gain and a lower proportion of large-for-gestational age newborns among intervention compared to control participants. The primary outcome at 12 months postpartum was maternal weight. Secondary outcomes included infant weight-for-age and weight-for-length z-scores. Results At 1 year, mothers in the intervention group weighed 96.3±18.6 kg, and in the control group, 99.7±19.2 kg. There was no significant difference between groups in change in weight from randomization to 1-year postpartum (b=-0.47, 95% CI [-4.03, 3.08]. There was a significant main effect of group for infant weight-for-age z-score (b=-0.40, 95% CI [-0.75,-0.05]) but not infant weight-for-length z-scores (b=-0.20, 95% CI [-0.59,0.20]. Conclusions A gestational weight management intervention did not influence maternal weight or infant weight-for-length at 1-year postpartum. Future studies may be warranted to determine if extending prenatal interventions into the postpartum period would be beneficial for maternal and infant outcomes.

Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta‐analysis of animal studies

“…In observational studies, maternal weight loss through bariatric surgery was associated with lower adiposity and improved lipids in offspring . However, only two lifestyle intervention showed a favorable effect on infants, while others found no effect on childhood anthropometry and cardiometabolic health …”

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

“…Previous studies confirm that despite a normal BMI at the beginning of pregnancy and gestational weight gain within recommendations some women still experienced excessive postpartum weight retention [48]. Other studies show that successful weight limiting effects, from interventions during pregnancy, do not remain one year postpartum [49]. How we succeed in helping women back to pre-pregnancy weight (or lower if their BMI is higher than 25 kg/m 2 ) affect the risk profile of any subsequent pregnancies as well as the risk for the mother to become obese.…”

Applying behavior change techniques to weight management during pregnancy: Impact on perinatal outcomes

“…Three additional trials followed the offspring of women participating in antenatal intervention trials to 6–12 months of age. 27–29 Again, no between-groups differences in infant weight were seen at follow up. Limitations of these trials included a high loss to follow up rate, 26,28 baseline differences between groups, 28,29 and minimal impact of the intervention on GWG.…”

“…Limited data suggests a potential benefit although the optimal intervention remains unclear. 27,28,30,31 …”