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Cited by 482Gestational Diabetes Research and ManagementMaternal and Neonatal HealthcareObesity, Physical Activity, Diet

Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial

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Dodd, J. M., Turnbull, D., McPhee, A. J., Deussen, A. R., Grivell, R. M., Yelland, L. N., Crowther, C. A., Wittert, G. +3 more·2014·BMJ
DOI 10.1136/bmj.g1285PMC PMC3919179
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Abstract

OBJECTIVE: To determine the effect of antenatal dietary and lifestyle interventions on health outcomes in overweight and obese pregnant women. DESIGN: Multicentre randomised trial. We utilised a central telephone randomisation server, with computer generated schedule, balanced variable blocks, and stratification for parity, body mass index (BMI) category, and hospital. SETTING: Three public maternity hospitals across South Australia. PARTICIPANTS: 2212 women with a singleton pregnancy, between 10+0 and 20+0 weeks' gestation, and BMI ≥ 25. INTERVENTIONS: 1108 women were randomised to a comprehensive dietary and lifestyle intervention delivered by research staff; 1104 were randomised to standard care and received pregnancy care according to local guidelines, which did not include such information. MAIN OUTCOME MEASURES: Incidence of infants born large for gestational age (birth weight ≥ 90th centile for gestation and sex). Prespecified secondary outcomes included birth weight >4000 g, hypertension, pre-eclampsia, and gestational diabetes. Analyses used intention to treat principles. RESULTS: 2152 women and 2142 liveborn infants were included in the analyses. The risk of the infant being large for gestational age was not significantly different in the two groups (lifestyle advice 203/1075 (19%) v standard care 224/1067 (21%); adjusted relative risk 0.90, 95% confidence interval 0.77 to 1.07; P=0.24). Infants born to women after lifestyle advice were significantly less likely to have birth weight above 4000 g (lifestyle advice 164/1075 (15%) v standard care 201/1067 (19%); 0.82, 0.68 to 0.99; number needed to treat (NNT) 28, 15 to 263; P=0.04). There were no differences in maternal pregnancy and birth outcomes between the two treatment groups. CONCLUSIONS: For women who were overweight or obese, the antenatal lifestyle advice used in this study did not reduce the risk delivering a baby weighing above the 90th centile for gestational age and sex or improve maternal pregnancy and birth outcomes. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).

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  • The aims of lifestyle pregnancy trials are to reduce the risk of pregnancy complications in the near term and chronic illness like obesity and diabetes in the longer term for both mother and future child.

    “The aims of lifestyle pregnancy trials are to reduce the risk of pregnancy complications in the near term, and chronic illness like obesity and diabetes in the longer-term for both “mother and future child” (Flynn et al. 2016; Dodd et al. 2014).”

    From The Politics of Postgenomic Reproduction: Exploring Pregnant Narratives from within a Clinical Trial (2022) · cites this paper as Dodd et al. 2014

    The Introduction describes the trial’s aim of improving maternal and infant outcomes during pregnancy, and the Discussion (Comparison with other studies) discusses the potential for longer-term prevention of obesity in children. The paper does not identify prevention of longer-term obesity or diabetes in mothers, or longer-term diabetes in children, as an aim of this trial. (LLM, conf=0.86)

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  • Studies that tested the effectiveness of lifestyle interventions provided during pregnancy on GDM have shown mixed results.

    “However, studies that tested the effectiveness of lifestyle interventions provided during pregnancy on GDM have shown mixed results [14, 17–21].”

    From Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus—a systematic review and meta-analysis of 257,876 pregnancies (2023) · cites this paper as [19]

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Research works printed but not linked: 35

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Authors
Dodd, J. M., Turnbull, D., McPhee, A. J., Deussen, A. R., Grivell, R. M., Yelland, L. N., Crowther, C. A., Wittert, G., Owens, J. A., Robinson, J. S., & for the LIMIT Randomised Trial Group
Affiliations
  • Women's and Children's Hospital (AU)
  • The University of Adelaide (AU)
Corresponding author
Dodd, J. M.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2014-02-10
Volume
348
Issue
feb10 3
Pages
g1285-g1285
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj.g1285
PMC
PMC3919179
OpenAlex
W1968288492
Cited by
482
References
3
Citations by year
2026: 6 · 2025: 29 · 2024: 22 · 2023: 27 · 2022: 30 · 2021: 39 · 2020: 42 · 2019: 50 · 2018: 64 · 2017: 52 · 2016: 45 · 2015: 51 · 2014: 22 · 2013: 1
FWCI
60.31
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc)
  • Own your potential (DEAKIN) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by-nc)
Funders
  • Medical Research Council
  • National Health and Medical Research Council (627005, 519240)
  • National Heart, Lung, and Blood Institute (R01HL094235)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
maternal overweight, maternal obesity, gestational weight gain, large for gestational age, birth weight, dietary intervention, gestational hypertension, preeclampsia, gestational diabetes mellitus
MeSH terms
Adult, Birth Weight, Female, Fetal Macrosomia, Gestational Age, Health Promotion, Humans, Hypertension, Infant, Newborn, Male, Obesity, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Diabetes, Gestational, Risk Reduction Behavior, Overweight, Weight Reduction Programs

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