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Table 2 A summary of the studies that met the criteria of the systematic review on lifestyle interventions in overweight and obese pregnant women: randomised trials

From: Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis

Author (year) Ethnic group/Country Participant/setting Sample size Intervention Outcome measure(s) Conclusion
Polley et al. (2002) [32] 31% black and 61% white/USA Recruited before 20 weeks of pregnancy (normal BMI > 19.5 to 24.9; overweight BMI ≥ 25 to < 30 kg/m2)/Hospital based 120, including 49 overweight
59 in control arm; 61 in intervention arm
Exercise and nutrition information (oral and newsletter) Personalised graphs and behavioural counselling. Gestational weight gain; gestational diabetes; Caesarean section; birthweight No statistically significant reduction in gestational weight, prevalence of gestational diabetes, Caesarean section, or large for gestational age baby
Hui et al. (2006) [33] Predominantly Caucasian/Canada Less than 26 weeks pregnant (community based and antenatal clinics). All BMI categories. Mean BMI of non-intervention arm = 25.7 (SD = 6.3) and for intervention arm = 23.4(SD = 3.9) 45
21 in non-intervention arm; 24 in intervention arm
Physical exercise (group-sessions home-based exercise)
Individualized nutrition plans
Gestational weight gain No statistically significant reduction in gestational weight gain
Wolff et al., 2008 [30] 100% Caucasian/Denmark Obese (BMI ≥ 30 kg/m2) women enrolled at 15 weeks' gestation 50 analysed
23 in control arm; 27 in intervention arm
Intensive intervention with 10 one-hour visits with a dietician at each antenatal visit, dietary guidance provided Gestational weight gain; gestational diabetes; Caesarean section; birthweight Statistically significant reduction in gestational weight gain, no statistically significant reduction in prevalence of gestational diabetes or Caesarean section, or birthweight
Jeffries et al., 2009 [28] > 90% Caucasian/Australia Women at or below 14 weeks' gestation. All BMI categories included 286
138 in control arm; 148 in intervention arm
Personalised weight measurement card (based on Institute of Medicine guidelines). Control had only single measurement at enrolment Gestational weight gain No statistically significant reduction in gestational weight gain.
Ong et al., 2009 [42] Predominantly Caucasian/Australia Pregnant obese women recruited at 18 weeks' gestation 12
six in control arm; six in intervention arm
Personalised 10 weeks of home-based supervised exercise (three sessions per week) Maternal aerobic fitness and gestational diabetes No statistically significant difference in aerobic fitness or gestational diabetes
Barakat et al., 2011 [41] 100% Caucasian/Spain All BMI categories 160
80 in control arm; 80 in intervention arm
Three group-based sessions per week, light resistance and toning exercise from the second trimester Gestational weight gain and birthweight No statistically significant difference in gestational weight gain and birth weight. Exercise intervention might attenuate adverse consequences of maternal BMI on newborn birth size
Asbee et al., 2009 [27] 26% African American/USA Pregnant women recruited before 16 weeks' gestation. All BMI categories except those of BMI > 40 kg/m2 100
43 in control arm; 53 in intervention arm
One session of dietetic counselling and activity Gestational weight gain; pregnancy outcome Statistically significant reduction in gestational weight gain. No effect on pregnancy outcome
Thornton et al., 2009 [29] 41% African American/USA Obese pregnant women (BMI ≥ 30 kg/m2) recruited between 12 and 28 weeks' gestation 257 randomised.
25 lost to follow up. 116 in control arm; 116 in intervention arm
Nutritional regime for gestational diabetes Gestational weight gain; gestational diabetes; Caesarean section; pregnancy outcome Statistically significant reduction in gestational weight gain, no statistically significant reduction in prevalence of gestational diabetes, Caesarean section or birthweight
Guelinckx et al., 2010 [26] 100% Caucasian/Belgium Obese (BMI > 30 kg/m2) women enrolled at 15 weeks' gestation. 195 randomised
85 analysed
65 in control arm; 65 in passive arm, 65 in intervention arm
Three arms: group sessions with a dietician; written brochures; and standard care
Dietary and physical activity guidance provided by dietician and in written brochures
Nutritional habits; gestational weight gain; gestational diabetes; Caesarean section; birthweight Improved nutritional habits; no statistically significant reduction in gestational weight gain, prevalence of gestational diabetes, Caesarean section or birthweight.
Phelan et al., 2011 [34] 67% White/USA Pregnant women BMI between 19.8 and 40 kg/m2 recruited between 10 and 16 weeks' gestation 401 randomised.
201 in non-intervention arm; 200 in intervention arm
Exercise and nutrition information (oral and newsletter) Personalised graphs and behavioural counselling Gestational weight gain; gestational diabetes; Caesarean section; pregnancy outcome Significant reduction in gestational weight gain; no statistically significant reduction in prevalence of gestational diabetes, Caesarean section or birthweight
Quinlivan et al., 2011 [59] 73% white, 19% Asian/Australia Pregnant women: overweight (BMI 25 to 29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) 132 randomised.
65 in non-intervention arm; 67 in intervention arm
Attended a study- specific antenatal clinic providing continuity of care, weighing on arrival, brief dietary intervention by food technologist and psychological assessment and intervention if indicated Gestational weight gain; gestational diabetes; birthweight Statistically significant reduction in gestational weight gain and prevalence of gestational weight gain. No statistically significant reduction in birthweight.
Luoto et al., 2011 [43] Predominantly white/Finland Pregnant women at risk of gestational diabetes. All BMI ranges 399 cluster randomised.
219 in non-intervention arm; 180 in intervention arm
Attended a study-specific individual antenatal lifestyle counselling clinic including group exercise Gestational diabetes; gestational weight gain; birthweight Statistically significant reduction in birthweight and macrosomia but no statistically significant difference in gestational diabetes
Nascimento et al., 2011 [44] Predominantly white/Brazil Pregnant women of all BMI categories 82 randomised.
42 in non-intervention arm; 40 in intervention arm
Attended a group-based exercise under supervision and received a home exercise counselling Gestational weight gain; raised blood pressure; perinatal outcome No statistically significant difference in gestational weight gain in terms of gestational weight gain, raised blood pressure or perinatal outcome
  1. BMI: body mass index; SD: standard deviation