Effect of a physical activity and healthy eating lifestyle intervention in pregnancy on fetal growth trajectories: The DALI randomised controlled trial
Open accessAbstract
BACKGROUND: Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed. OBJECTIVES: This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories. METHODS: and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed. RESULTS: Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of -54.1 g (-146.7 to 38.9 g), -84.9 g (-194.0 to 24.7 g), and -99.8 g (-227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of -185.8 g (-362.5 g to -9.2 g) versus -23.4 g (-190.4 g to 143.5 g) in females. CONCLUSIONS: A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.
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In the DALI lifestyle intervention, combined diet and activity counseling resulted in attenuated fetal growth trajectories in male offspring, highlighting potential sex-specific responses to interventions.
“In the DALI lifestyle intervention, combined diet and activity counseling resulted in attenuated fetal growth trajectories in male offspring, highlighting potential sex-specific responses to interventions [184].”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [184]
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- Authors
- Dieberger, A. M., van Poppel, M. N. M., Desoye, G., Simmons, D., Harreiter, J., Devlieger, R., Medina, C., Lawlor, D. A., Elhakeem, A., & the DALI core investigator group
- Affiliations
- Medical University of Graz (AT)
- Department of Human Movement Science, Sport and Health University of Graz Graz Austria
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
- Camden and Campbelltown Hospitals (AU)
- Medical University of Vienna (AT)
- Universitair Ziekenhuis Leuven (BE)
- Hospital de Sant Pau (ES)
- MRC Integrative Epidemiology Unit at the University of Bristol Bristol UK
- University of Bristol (GB)
- ORCID
- Venue
- Pediatric Obesity
- Publisher
- Wiley
- Published
- 2025-01-19
- Volume
- 20
- Issue
- 5
- Pages
- e13199-e13199
- ISSN
- 2047-6302 (ISSN-L)
- 2047-6310
- PMC
- PMC12001303
- OpenAlex
- W4406591426
- Cited by
- 7
- References
- 43
- Citations by year
- 2026: 2 · 2025: 5
- FWCI
- 8.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Pediatric Obesity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion, cc-by)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- Explore Bristol Research (submittedVersion, cc-by)
- Funders
- ZonMw (200310013)
- European Commission (101021566, 242187)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- maternal obesity, pregnancy, fetal growth, fetal growth trajectories, physical activity, healthy eating, lifestyle intervention, estimated fetal weight, gestational weight gain, sex differences, fetal overgrowth, gestational diabetes mellitus
- MeSH terms
- Healthy Lifestyle, Diet, Healthy, Adult, Female, Humans, Male, Obesity, Pregnancy, Pregnancy Complications, Exercise, Fetal Development
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