title: Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial.
abstract: BACKGROUND
  Excessive weight gain during pregnancy is a risk factor for postpartum weight retention and future weight gain and obesity. Whether a behavioral intervention in pregnancy can reduce long-term weight retention is unknown.
  
  
  OBJECTIVE
  This randomized trial tested whether a low-intensity behavioral intervention to prevent excessive gestational weight gain could increase the proportion of women who returned to prepregnancy weight by 12 mo postpartum.
  
  
  METHODS
  Women (n = 401, 13.5 wk of gestation, 50% normal weight, 50% overweight/obese) were randomly assigned into an intervention or control group; 79% completed the 12-mo assessment. The telephone-based intervention targeted gestational weight gain, healthy eating, and exercise and was discontinued at delivery.
  
  
  RESULTS
  In modified intent-to-treat analyses that excluded women with miscarriages (n = 6), gestational diabetes (n = 32), or subsequent pregnancies (n = 32), the intervention had no significant effect on the odds of achieving prepregnancy weight at 12 mo postpartum (n = 331; 35.4% compared with 28.1%; P = 0.18). Completer analyses suggested that the intervention tended to increase the percentages of women who reached prepregnancy weight (n = 261; 45.3% compared with 35.3%; P = 0.09) and significantly reduced the magnitude of mean ± SD postpartum weight retained (1.4 ± 6.3 compared with 3.0 ± 5.7 kg; P = 0.046) at 12 mo. Women in the intervention group reported higher dietary restraint through 6 mo postpartum (P = 0.023) and more frequent self-monitoring of body weight (P < 0.02 for all) throughout the study.
  
  
  CONCLUSIONS
  A low-intensity behavioral intervention in pregnancy can reduce 12-mo postpartum weight retention and improve dietary restraint and self-weighing in study completers. Future research is needed to test the long-term effects of more intensive behavioral interventions in pregnancy. This trial was registered at clinicaltrials.gov as NCT01117961.
authors.affiliation: Kinesiology Department (SP) and Statistics Department (AS and KG), California Polytechnic State University, San Luis Obispo, CA; the Warren Alpert Medical School, Department of Psychiatry and Human Behavior, and The Miriam Hospital, Weight Control and Diabetes Research Center, Brown University, Providence, RI (SP, RRW, and FD); the Department of Obstetrics and Gynecology and Women & Infants Hospital of Rhode Island, Division of Research, Warren Alpert Medical School, Brown University, Providence, RI (MGP); and the University of California, Berkeley, School of Public Health, Berkeley, CA (BA).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Phipps
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
authors.forename: Francine
authors.initials: F
authors.lastname: Darroch
authors.forename: Kelsey
authors.initials: K
authors.lastname: Grantham
authors.forename: Andrew
authors.initials: A
authors.lastname: Schaffner
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D004032:Diet; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D009765:Obesity / Q000517:prevention & control*; D050177:Overweight / Q000517:prevention & control*; D010865:Pilot Projects; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D012307:Risk Factors; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D015430:Weight Gain / Q000502:physiology*; D055815:Young Adult