Prenatal education of overweight or obese pregnant women to prevent childhood overweight (the ETOIG study): an open-label, randomized controlled trial

Parat, Sophie; Nègre, Véronique; Baptiste, Amandine; Valensi, P.; Bertrand, Anne-Marie; Chollet, C.; Dabbas-Tyan, M.; Altman, Jean-Jacques; Lapillonne, Alexandre; Tréluyer, Jean‐Marc; Elie, Caroline; Tauber, Maïthé; Lorenzini, F.; Cosson, E.

doi:10.1038/s41366-018-0205-z

Cited by 22 publications

(45 citation statements)

References 27 publications

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“…The current study found no difference in GWG among women who did and did not receive PNC. This is similar to other studies that have found no difference in GWG [25,26] or postpartum weight retention [27] among women who received a nutritional education intervention compared to standard-of-care prenatal visits. However, a systematic review and meta-analysis demonstrated an overall reduction in GWG of 0.45 kg among intervention studies that provided nutrition counseling to pregnant women [28], which is in contradiction to the current study.…”

Section: Discussionsupporting

confidence: 90%

“…This is similar to the current study that found higher birthweights among women who received PNC. A recent publication found that prenatal nutrition education did not result in a decreased incidence of rapid infant weight gain in the first two years of life or elevated offspring BMI percentile at two years of age [27]. The results of the present study are similar as we found no differences in infant weight at 12 months among women by receipt of PNC.…”

Section: Discussionsupporting

confidence: 87%

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Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

et al. 2019

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It is recommended that prenatal care include nutrition counseling; however, <70% of women report receipt of nutrition counseling during pregnancy. In this study, we aimed to characterize prenatal nutrition counseling (PNC) among large-for-gestational age deliveries at a low-income and minority-serving hospital by performing a retrospective chart review of infants with a birth weight > 4000 g. Of the 2380 deliveries, 165 met the inclusion criteria. Demographics, PNC receipt, and pregnancy outcomes were compared among normal-weight (NW; BMI: 18.5–24.9 kg/m2, 19%, n = 31), overweight (OW; BMI: 25–29.9 kg/m2, 29%, n = 48), and obese (OB; BMI > 30 kg/m2, 52%, n = 86) women. The majority (78%, n = 129) of women were Hispanic White with a mean age of 30.4 ± 5.7 yrs and gestational weight gain of 12.1 ± 5.8 kgs. A total of 62% (n = 103) of women received PNC. A total of 57% gained above the Institute of Medicine (IOM) recommendations (n = 94). OB women were 2.6 and 2.1 times more likely to receive PNC than OW (95% CI: 1.1–2.0) and NW (95% CI: 0.9–1.9) women, respectively. Women who gained within the IOM recommendations for their pre-pregnancy body mass index (BMI) were 50% less likely to receive PNC than women who gained above the IOM recommendations for their pre-pregnancy weight (χ = 4.45, p = 0.035; OR = 0.48, CI: 0.24 to 0.95). Infant birthweight was significantly higher among women who received PNC (4314 ± 285 vs. 4197 ± 175 g, p = 0.004). These data suggest that PNC was directed toward women who enter pregnancy in the obese weight category and/or gain excessively across gestation. Future studies should provide PNC to all women to evaluate whether it reduces the risk of delivering large-for-gestational age deliveries across all maternal weight categories. Additionally, more work is needed to identify the types of PNC that are most effective for this high-risk population.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

et al. 2019

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“…67686970717273747576777879808182838485868788 A further 45 trials (9945 women)8990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133 were identified after the IPD acquisition timeline until February 2017.…”

Section: Resultsmentioning

confidence: 99%

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

2017

BMJ

268

184

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ObjectiveTo synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women's body mass index, age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications. DESIGNSystematic review and meta-analysis of individual participant data (IPD). DATA SOURCESMajor electronic databases from inception to February 2017 without language restrictions. ELIGIBILITY CRITERIA FOR SELECTING STUDIESRandomised trials on diet and physical activity based interventions in pregnancy. DATA SYNTHESISStatistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall, and in subgroups (interactions). RESULTS IPD CONCLUSIONDiet and physical activity based interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. There is no evidence that effects differ across subgroups of women.

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“…After duplicate removal, and title and abstract screening, 230 references were selected for full‐text review. One hundred and eighty eligible studies were identified, describing 39 trials, comprising 46 interventions . Five trials had more than one eligible intervention arm .…”

Section: Resultsmentioning

confidence: 99%

“…Six interventions showed positive impacts on child adiposity/weight outcomes only . The Early Obesity Intervention Programme, which focused on infant physical activity, had a positive impact on sum of skinfolds and suprailiacal skinfolds (mm) at follow‐up at child aged 2.5 years (primary outcome; 19 months from intervention end) .…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of health professional‐delivered interventions during the first 1000 days to prevent overweight/obesity in children: A systematic review

et al. 2019

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Childhood obesity is a global public health challenge. Early prevention, particularly during the first 1000 days, is advocated. Health professionals have a role to play in obesity prevention efforts, in part due to the multiple routine contacts they have with parents. We synthesized the evidence for the effectiveness of obesity prevention interventions delivered by health professionals during this time period, as reviews to date have not examined effectiveness by intervention provider. We also explored what behaviour change theories and/or techniques were associated with more effective intervention outcomes. Eleven electronic databases and three trial registers were searched from inception to 04 April 2019. A total of 180 studies, describing 39 trials involving 46 intervention arms, were included. While the number of interventions has grown considerably, we found some evidence for the effectiveness of health professional-delivered interventions during the first 1000 days. Only four interventions were effective on a primary (adiposity/weight) and secondary (behavioural) outcome measure. Twenty-two were effective on a behavioural outcome only. Several methodological limitations were noted, impacting on efforts to establish the active ingredients of interventions. Future work should focus on the conduct and reporting of interventions.

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Prenatal education of overweight or obese pregnant women to prevent childhood overweight (the ETOIG study): an open-label, randomized controlled trial

Cited by 22 publications

References 27 publications

Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

The effectiveness of health professional‐delivered interventions during the first 1000 days to prevent overweight/obesity in children: A systematic review

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