What characteristics of nutrition and physical activity interventions are key to effectively reducing weight gain in obese or overweight pregnant women? A systematic review and meta‐analysis
Abstract
Lifestyle interventions targeting gestational weight gain (GWG) report varying degrees of success. To better understand factors influencing efficacy, we reviewed randomized trials specifically among obese and overweight pregnant women. METHODS: We conducted a systematic review and a meta-analysis of 32 studies with a pooled population of 5,869 overweight or obese pregnant women. Random effects models were fit to compute the weighted mean difference (WMD) in GWG between groups across studies. Subgroup analyses were conducted to compare intervention efficacy in overweight vs. obese pregnant women, and interventions delivered by prenatal care providers (PCPs) vs. non-PCPs during pregnancy. Moderator analyses ensured. RESULTS: Nine (28%) of 32 studies reported significant reductions in GWG in response to intervention. Of these, six (66%) of nine were delivered by PCPs. Overall, the WMD in GWG was -1.71 (95% confidence interval [CI]: -2.55, -0.86) kg. However, interventions delivered by PCPs yielded a significantly greater reduction in GWG compared to interventions delivered by non-PCPs (WMD = -3.88 kg; 95% CI: -7.01, -0.75 vs. -0.80 kg; 95% CI: -1.32, -0.28; p for difference = 0.005). CONCLUSION: When PCPs counsel nutrition and physical activity, obese and overweight pregnant women have greater success meeting GWG targets and may be more motivated to modify their behaviour than with other modes of intervention deliveries.
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Interventions appear to be more effective if delivered by clinicians rather than non-clinical staff.
“Physical activity‐based interventions were generally ineffective. Interventions appear to be more effective if delivered by clinicians rather than non‐clinical staff. 131”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [131]
In highly educated women, only diet-based interventions were successful.
“In women of low education, diet‐based and mixed approaches reduced the risk of excessive GWG, whereas, in highly educated women, only diet‐based interventions were successful.”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [131]
In women of low education, diet-based and mixed approaches reduced the risk of excessive GWG.
“In women of low education, diet‐based and mixed approaches reduced the risk of excessive GWG, whereas, in highly educated women, only diet‐based interventions were successful.”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [131]
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- Authors
- Yeo, S., Walker, J. S., Caughey, M. C., Ferraro, A. M., & Asafu‐Adjei, J. K.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- School of Public Health, Department of Biostatistics University of North Carolina at Chapel Hill Chapel Hill NC USA
- Corresponding author
- Yeo, SeonAe
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2017-02-08
- Volume
- 18
- Issue
- 4
- Pages
- 385-399
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2586615091
- Cited by
- 85
- References
- 7
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 17 · 2022: 6 · 2021: 12 · 2020: 10 · 2019: 9 · 2018: 18 · 2017: 3
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Advancing Translational Sciences (1UL1TR001111)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK093002)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- gestational weight gain, maternal obesity, overweight in pregnancy, lifestyle intervention, nutrition counseling, physical activity counseling, prenatal care providers, intervention delivery mode, weight gain reduction
- MeSH terms
- Diet, Female, Humans, Obesity, Pregnancy, Pregnancy Complications, Prenatal Care, Weight Gain, Exercise, Randomized Controlled Trials as Topic, Treatment Outcome, Pregnant People, Pregnant Women, Maternal Nutritional Physiological Phenomena, Overweight
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