The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials.
Child follow-up of pregnancy intervention studies
Childhood obesity
Individual participant data meta-analysis
Journal
BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723
Informations de publication
Date de publication:
02 06 2021
02 06 2021
Historique:
received:
11
01
2021
accepted:
27
04
2021
entrez:
2
6
2021
pubmed:
3
6
2021
medline:
16
10
2021
Statut:
epublish
Résumé
The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown. We conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10 Seven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures. In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions. PROSPERO, CRD42016047165.
Sections du résumé
BACKGROUND
The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown.
METHODS
We conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10
RESULTS
Seven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures.
CONCLUSIONS
In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions.
TRIAL REGISTRATION
PROSPERO, CRD42016047165.
Identifiants
pubmed: 34074261
doi: 10.1186/s12916-021-01995-6
pii: 10.1186/s12916-021-01995-6
pmc: PMC8170974
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
128Références
Curr Opin Pediatr. 2015 Apr;27(2):248-53
pubmed: 25635586
Int J Obes (Lond). 2020 Jul;44(7):1531-1535
pubmed: 32203109
Child Obes. 2017 Apr;13(2):93-101
pubmed: 27854513
Lancet Diabetes Endocrinol. 2017 Jan;5(1):65-76
pubmed: 27743974
PLoS Med. 2011 May;8(5):e1001036
pubmed: 21610860
PLoS One. 2011;6(6):e20476
pubmed: 21694759
Stat Med. 2017 Feb 28;36(5):855-875
pubmed: 27747915
Nutrients. 2016 Jan 04;8(1):
pubmed: 26742066
JAMA. 2015 Apr 28;313(16):1657-65
pubmed: 25919529
Pediatr Obes. 2021 Mar;16(3):e12725
pubmed: 32914569
Diabetes Care. 2011 Dec;34(12):2502-7
pubmed: 21972411
Acta Obstet Gynecol Scand. 2014 Aug;93(8):794-801
pubmed: 24834792
Best Pract Res Clin Endocrinol Metab. 2012 Oct;26(5):627-39
pubmed: 22980045
MMWR Morb Mortal Wkly Rep. 2014 Aug 8;63(31):671-6
pubmed: 25102415
Front Public Health. 2017 Apr 13;5:58
pubmed: 28451584
Lancet Diabetes Endocrinol. 2015 Oct;3(10):767-77
pubmed: 26165396
PLoS One. 2015 Jul 20;10(7):e0133041
pubmed: 26192183
Stat Med. 2017 Feb 28;36(5):772-789
pubmed: 27910122
BMJ. 2014 Feb 10;348:g1285
pubmed: 24513442
BMJ. 2014 Mar 04;348:g1739
pubmed: 24598079
Stat Methods Med Res. 2018 Jun;27(6):1634-1649
pubmed: 27647809
BMJ. 2017 Jul 19;358:j3119
pubmed: 28724518
Obes Facts. 2020;13(2):256-266
pubmed: 32268328
Am J Obstet Gynecol. 2014 Feb;210(2):134.e1-9
pubmed: 24060449
Stat Med. 2020 Jul 10;39(15):2115-2137
pubmed: 32350891
PLoS One. 2014 Feb 24;9(2):e89590
pubmed: 24586896
Int J Obes (Lond). 2017 Jul;41(7):1018-1026
pubmed: 28216644
Int J Obes (Lond). 2013 Jun;37(6):814-21
pubmed: 23032404
PLoS Med. 2019 Jun 11;16(6):e1002817
pubmed: 31185012
BMC Med. 2014 Oct 13;12:161
pubmed: 25315237
Ann Nutr Metab. 2013;62 Suppl 3:27-36
pubmed: 23970213
J Clin Endocrinol Metab. 2015 Jan;100(1):175-83
pubmed: 25343235
BMJ. 2012 Aug 30;345:e5605
pubmed: 22936795
BMC Med. 2014 Oct 13;12:163
pubmed: 25315325
Stat Med. 2020 Aug 30;39(19):2536-2555
pubmed: 32394498
PLoS One. 2016 Aug 25;11(8):e0161206
pubmed: 27560495
Syst Rev. 2017 Mar 9;6(1):51
pubmed: 28274270
Stat Med. 2016 Jul 30;35(17):2938-54
pubmed: 26681666
BMJ. 2005 Jun 11;330(7504):1357
pubmed: 15908441
J Steroid Biochem Mol Biol. 2019 Apr;188:111-116
pubmed: 30605775
Z Gesundh Wiss. 2016;24(5):427-436
pubmed: 27695668