Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Overweight and obesity pose a big challenge to pregnancy as they are associated with adverse maternal and perinatal outcome. Evidence of lifestyle intervention resulting in improved pregnancy outcome is conflicting. Hence the objective of this study is to determine the efficacy of antenatal dietary, activity, behaviour or lifestyle interventions in overweight and obese pregnant women to improve maternal and perinatal outcomes. METHODS: A systematic review and meta-analyses of randomised and non-randomised clinical trials following prior registration (CRD420111122 http://www.crd.york.ac.uk/PROSPERO) and PRISMA guidelines was employed. A search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, Maternity and Infant care and eight other databases for studies published prior to January 2012 was undertaken. Electronic literature searches, study selection, methodology and quality appraisal were performed independently by two authors. Methodological quality of the studies was assessed according to Cochrane risk of bias tool. All appropriate randomised and non-randomised clinical trials were included while exclusions consisted of interventions in pregnant women who were not overweight or obese, had pre-existing diabetes or polycystic ovarian syndrome, and systematic reviews. Maternal outcome measures, including maternal gestational weight gain, gestational diabetes and Caesarean section, were documented. Fetal outcomes, including large for gestational age and macrosomia (birth weight > 4 kg), were also documented. RESULTS: Thirteen randomised and six non-randomised clinical trials were identified and included in the meta-analysis. The evidence suggests antenatal dietary and lifestyle intervention in obese pregnant women reduces maternal pregnancy weight gain (10 randomised clinical trials; n = 1228; -2.21 kg (95% confidence interval -2.86 kg to -1.59 kg)) and a trend towards a reduction in the prevalence of gestational diabetes (six randomised clinical trials; n = 1,011; odds ratio 0.80 (95% confidence interval 0.58 to 1.10)). There were no clear differences reported for other outcomes such as Caesarean delivery, large for gestational age, birth weight or macrosomia. All available studies were assessed to be of low to medium quality. CONCLUSION: Antenatal lifestyle intervention is associated with restricted gestational weight gain and a trend towards a reduced prevalence of gestational diabetes in the overweight and obese population. These findings need to be interpreted with caution as the available studies were of poor to medium quality.
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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 [21]
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“However, studies that tested the effectiveness of lifestyle interventions provided during pregnancy on GDM have shown mixed results [14, 17 – 21].”
ResultCatov, J. M., Sun, B., Bertolet, M., Snyder, G. G., Lewis, C. E., Allen, N. B., Shikany, J. M., Ingram, K. H., Appiah, D., & Gunderson, E. P. (2020) · Obesity · doi:10.1002/oby.22848 · Cited by 15 · see citing works
- Authors
- Oteng-Ntim, E., Varma, R., Croker, H., Poston, L., & Doyle, P.
- Affiliations
- St Thomas' Hospital (GB)
- University College London (GB)
- King's College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- Venue
- BMC Medicine
- Published
- 2012-05-10
- Volume
- 10
- Issue
- 1
- Pages
- 47-47
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC3355057
- OpenAlex
- W2052061359
- Cited by
- 352
- References
- 6
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 9 · 2023: 14 · 2022: 16 · 2021: 22 · 2020: 23 · 2019: 25 · 2018: 24 · 2017: 32 · 2016: 37 · 2015: 46 · 2014: 43 · 2013: 30 · 2012: 11
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (RP-0407-10 452, RP-PG-0407-10452)
- Guy's and St Thomas' Charity
- Programme Grants for Applied Research (RP‐0407‐10452)
- 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
- maternal obesity, overweight in pregnancy, dietary intervention, physical activity, gestational weight gain, gestational diabetes mellitus, cesarean section, large for gestational age, macrosomia, perinatal outcomes, maternal outcomes, birth weight
- MeSH terms
- Behavior Therapy, Clinical Trials as Topic, Diet, Female, Humans, Life Style, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Exercise, Overweight
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