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Table 3 Summary of the studies that met the criteria of the systematic review on lifestyle interventions in overweight and obese pregnant women: non-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

Participants/setting

Sample size

Intervention

Outcome measure(s)

Conclusion

Gray-Donald et al. (2000) [38]

Native Americans/Canada

Recruited before the 26th week of pregnancy, non-parallel recruitment of control and intervention arms.

Mean BMI = 29.6 kg/m2 (SD = 6.45) in non-intervention arm and mean BMI = 30.8 kg/m2 (SD = 6.85) in intervention arm at baseline.

219

107 in non-intervention arm; 112 in intervention arm

Dietary and weight counselling

Exercise groups provided

Gestational weight gain; gestational diabetes;

Caesarean section;

birthweight;

postpartum weight retention

No statistically significant difference in gestational weight gain, prevalence of gestational diabetes, Caesarean section or large for gestational age baby

Olson et al. (2004) [51]

96% white/USA

Recruited before third trimester. Hospital and clinic setting

BMI range: 19.8 to 29 kg/m2

498

381 in non-intervention arm; 117 in the intervention arm

Used the Institute of Medicine recommended guidelines on weight gain; 'health book' used to record diet and exercise and contained healthy eating and exercise information

Gestational weight gain; birthweight

No statistically significant reduction in gestational weight gain or prevalence of large for gestational age baby

Claesson et al. (2007) [36]

Not stated. Predominantly Caucasian/Sweden

Obese and registered at antenatal care clinic.

BMI ≥ 30 kg/m2

348

193 in non-intervention arm; 155 in intervention arm

Nutritional habits interview, weekly counselling and aqua aerobic sessions

Gestational weight gain; Caesarean section.

Statistically significant reduction in gestational weight gain; no difference in prevalence of Caesarean section

Kinnunen et al. (2007) [37]

Over 90% Caucasian/Finland

First-time pregnant women who were obese (BMI ≥ 30 kg/m2)

196

95 in non-intervention arm; 101 in intervention arm

Individual counselling at each antenatal visits. Dietary guidance and optional activity sessions.

Gestational weight gain; diet change; birthweight

No statistically significant reduction in gestational weight gain or prevalence of large for gestational age baby. Statistically significant reduction in dietary glycaemic load.

Shirazian et al., 2010 [39]

33% blacks; 67% Latino/USA

Singleton obese (≥ 30 kg/m2) pregnant women recruited in the first trimester. Historical non-intervention group.

54

28 in non-parallel control arm; 28 in intervention arm)

One-to-one counselling; six structured seminars on healthy living (healthy eating and walking)

Gestational weight gain; gestational diabetes; Caesarean section

Statistically significant reduction in gestational weight gain; no difference in prevalence of gestational diabetes

Mottola et al., (2010) [35]

Not stated/Canada

Overweight (BMI ≥ 25 to 29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) pregnant women recruited before 16 weeks' gestation; historical non-intervention group.

65 matched non-parallel control of 260

Individualised nutrition plan; exercise consisted of walking (three to four times per week, used pedometers)

Gestational weight gain; Caesarean section; birthweight; peripartum weight retention

Possible reduction in gestational weight gain; no difference in prevalence of Caesarean section or large for gestational age baby; minimal effect on peripartum weight retention

  1. BMI: body mass index; SD: standard deviation.