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

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*

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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

OriginalsprogEngelsk
Artikelnummer128
TidsskriftBMC Medicine
Vol/bind19
Antal sider15
ISSN1741-7015
DOI
StatusUdgivet - 2. jun. 2021

Bibliografisk note

Funding Information:

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.

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