Journal
BMC MEDICINE
Volume 17, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12916-018-1235-z
Keywords
Lifestyle intervention; gestational weight gain; diet; exercise; gestational diabetes; weight retention; childhood obesity; obesity prevention; pregnancy; obstetric outcomes
Categories
Funding
- Else Kroner-Fresenius Centre for Nutritional Medicine at the Technical University of Munich
- Competence Centre for Nutrition (KErn) in Bavaria
- Bavarian State Ministry of Food, Agriculture and Forestry
- Bavarian State Ministry of Health and Care (Health Initiative Gesund.Leben.Bayern)
- AOK Bayern - the largest statutory health insurance in Bavaria
- DEDIPAC consortium by the Joint Programming Initiative (JPI) A Healthy Diet for a Healthy Life
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Excessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity. The GeliS study examines the effect of a lifestyle intervention during pregnancy on the proportion of women with excessive GWG and pregnancy and obstetric complications, as well as the long-term risk of maternal and infant obesity. The GeliS study is a cluster-randomised multicentre controlled trial including 2286 women with a pre-pregnancy BMI between 18.5 and 40.0 kg/m(2) recruited from gynaecological and midwifery practices prior to the end of the 12(th) week of gestation in five Bavarian regions. In the intervention regions, four lifestyle counselling sessions covering a balanced healthy diet, regular physical activity and self-monitoring of weight gain were performed by trained healthcare providers alongside routine pre- and postnatal practice visits. In the control regions, leaflets with general recommendations for a healthy lifestyle during pregnancy were provided. The intervention did not result in a significant reduction of women showing excessive GWG (adjusted OR 0.95, 95% CI 0.66-1.38, p = 0.789), with 45.1% and 45.7% of women in the intervention and control groups, respectively, gaining weight above the Institute of Medicine recommendations. Gestational diabetes mellitus was diagnosed in 10.8% and 11.1% of women in the intervention and control groups, respectively (p = 0.622). Mean birth weight and length were slightly lower in the intervention group (3313 +/- 536 g vs. 3363 +/- 498 g, p = 0.020; 51.1 +/- 2.7 cm vs. 51.6 +/- 2.5 cm, p = 0.001). In the setting of routine prenatal care, lifestyle advice given by trained healthcare providers was not successful in limiting GWG and pregnancy complications. Nevertheless, the potential long-term effects of the intervention remain to be assessed.
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