Journal
BMC MEDICINE
Volume 19, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12916-021-01995-6
Keywords
Individual participant data meta-analysis; Child follow-up of pregnancy intervention studies; Childhood obesity
Categories
Funding
- Australian National Health and Medical Research Council (NHMRC) [1143773]
- NHMRC Practitioner Fellowship [1078980]
- National Health and Medical Research Council of Australia [1078980, 1143773] Funding Source: NHMRC
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This study shows that dietary and/or lifestyle interventions in overweight and obese pregnant women do not alter the risk of early childhood obesity. Future research may need to focus on pre-conception and early childhood interventions.
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/m(2) 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.
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