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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
Author(s) -
Yeo SeonAe,
Walker Jennifer S.,
Caughey Melissa C.,
Ferraro Amanda M.,
AsafuAdjei Josephine K.
Publication year - 2017
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.12511
Subject(s) - overweight , medicine , meta analysis , psychological intervention , pregnancy , weight gain , randomized controlled trial , confidence interval , obesity , body mass index , population , obstetrics , subgroup analysis , physical therapy , pediatrics , body weight , environmental health , psychiatry , biology , genetics
Summary 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.