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09.08.2017 Category: News

The effect of diet and physical activity based interventions in pregnancy


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Half of all women of childbearing age worldwide are overweight or obese. This puts mothers and babies at risk, both in pregnancy and in later life. A team of researchers from the International Weight Management in Pregnancy (i-WIP) Collaborative Group around Professor Khan therefore assessed if diet and physical activity based interventions have an effect on limiting gestational weight gain and on the health of mothers and their infants. As recently published in the British Medical Journal (BMJ), the scientists showed that diet, physical and lifestyle interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. 

Data sources for individual participant data (IPD) were major electronic databases (i.e. Medline, Embase, etc.). In total, the group of researchers obtained individual participant data of 12 526 women from 36 randomised trials in 16 countries. Khan et al. analysed these data in a systematic literature review and a meta-analysis (a statistical analysis that combines the results of multiple scientific studies) to explore the differential effects of interventions based on diet and physical activity during pregnancy. They focused primarily on gestational weight gain and on the health outcomes for mothers and babies, according to women’s body mass index (BMI), age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications. Analysed effects on maternal health included gestational diabetes mellitus, hypertensive disorders of pregnancy, preterm delivery, and caesarean section. Effects on infant health included stillbirth, small for gestational age fetus, large for gestational age fetus, and admission of the newborn to a neonatal intensive care unit. 

Their meta-analysis of the individual participant data confirmed that diet and physical activity based interventions in pregnancy reduce the amount of weight gained between conception and just before the birth of the infant. This beneficial effect was consistently observed irrespective of maternal body mass index (BMI), age, parity, ethnicity, or pre-existing medical condition. The authors also found that these interventions lowered the risk of caesarean section and had no effect on the health of the fetus and of the newborn infant. 

Because the study showed that it is likely that women of all BMI groups could benefit from specific advice on diet, care and lifestyle, the researchers recommend that healthcare professionals should provide such advice to mothers regardless of ethnicity, age, and underlying medical conditions. Further implications for clinical practice are that doctors should reassure mothers about the safety of the interventions, particularly on physical activity and structured exercise in pregnancy, by highlighting the benefits and lack of harm. The findings also suggest that such interventions in pregnancy could be considered in global efforts to reduce the rate of caesarean section births. 

 

View more (British Medical Journal)


 
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