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The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials

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Jennie Louise, Amanda J. Poprzeczny, Andrea R. Deussen, Christina Vinter, Mette Tanvig, Dorte Moller Jensen, Annick Bogaerts, Roland Devlieger, Fionnuala M. McAuliffe, Kristina M. Renault, Emma Carlsen, Nina Geiker, Lucilla Poston, Annette Briley, Shakila Thangaratinam, Jodie M. Dodd

Original languageEnglish
Article number128
JournalBMC Medicine
Volume19
Issue number1
DOIs
PublishedDec 2021

Bibliographical note

Funding Information: We are indebted to the women and their children who participated in the studies contributing data to this IPDMA. We also acknowledge the staff and research students who worked on the trials and child follow-up of the respective individual studies, namely the LIMIT Trial Group, the UPBEAT Consortium including Kathryn Dalrymple, ROLO study from UCD Perinatal Research Centre including John Mehegan, the TOP Study Group including Mads Lind, the LiP Trial Team and the Bogaerts trial study staff and students from the University of Antwerp, University Colleges Limburg and KU Leuven. Funding Information: This project was funded by the Australian National Health and Medical Research Council (NHMRC) Project Grant ID 1143773. Jodie Dodd is supported by NHMRC Practitioner Fellowship ID 1078980. The funders played no role in the conduct of this work, review, analysis or interpretation of findings and were not involved in the preparation of this manuscript. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Background: The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown. Methods: We conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10+0 and 20+0 weeks and body mass index (BMI) ≥ 25 kg/m2 in early pregnancy were randomised to a diet and/or lifestyle intervention or continued standard antenatal care and in which longer-term maternal and child follow-up at 3–5 years of age had been undertaken. The primary childhood outcome was BMI z-score above the 90th percentile. Secondary childhood outcomes included skinfold thickness measurements and body circumferences, fat-free mass, dietary and physical activity patterns, blood pressure, and neurodevelopment. Results: Seven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures. Conclusions: In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions. Trial registration: PROSPERO, CRD42016047165

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