title: Lifestyle intervention to prevent excessive maternal weight gain: mother and infant follow-up at 12 months postpartum.
abstract: BACKGROUND
  Excessive gestational weight gain (GWG) is associated with elevated weight retention in mothers and might be related to adiposity of their offspring. Little is known if lifestyle intervention during pregnancy has beneficial effects for mothers and children beyond gestation.
  
  
  METHODS
  A cluster-randomized controlled intervention trial was performed with 250 pregnant women in 8 gynaecological practices. Lifestyle intervention was carried out twice with individual counselling sessions on nutrition, physical activity and weight monitoring. Participants in the control group received routine prenatal care and an information leaflet. Follow-up data of women and their offspring were collected one year postpartum (pp) by phone call and/or via e-mail using a structured questionnaire. Maternal weight retention at 12 months pp and weight development of the children in their first year of life was compared between groups using linear regression. The association between energy and macronutrient intake during pregnancy with maternal weight retention and children weight development was also assessed.
  
  
  RESULTS
  The intervention resulted in a trend towards lower mean weight retention 12 months pp (0.2 vs. 0.8 kg), but was not statistically significant (p = 0.321). Among women receiving lifestyle counselling, only 8% retained more than 5 kg weight while 17% in the control group retained >5 kg (OR: 0.40 (95% CI: 0.16, 0.97)). For the whole study cohort, an association between higher GWG and increased 12 month weight retention was found (0.4 kg weight retention per 1 kg increase in GWG, p < 0.001). Weight development of the infants did not differ between groups in the first months after birth. At the 10th-12th month weight measurement, infants born to mothers in the intervention group tended towards lower body weights. Both energy intake and macronutrient composition of the diet during pregnancy did not affect maternal weight retention and weight development of the infants.
  
  
  CONCLUSIONS
  Lifestyle counselling during pregnancy to avoid GWG had a rather modest effect on maternal pp weight retention and weight development of the infants. However, larger intervention studies and longer follow-up are required to be able to draw definite conclusions.
  
  
  BACKGROUND
  German Clinical Trials Register DRKS00003801.
authors.affiliation: ZIEL - Research Centre for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany. Kathrin.Rauh@KErn.bayern.de.|Competence Centre for Nutrition (KErn), Freising, Germany. Kathrin.Rauh@KErn.bayern.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Rauh
authors.affiliation: ZIEL - Research Centre for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany. julia.guenther@tum.de.|Else Kröner-Fresenius-Center for Nutritional Medicine, Chair of Nutritional Medicine, Technische Universität München, Freising-Weihenstephan, Germany. julia.guenther@tum.de.|Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. julia.guenther@tum.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Günther
authors.affiliation: ZIEL - Research Centre for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany. julia.kunath@tum.de.|Else Kröner-Fresenius-Center for Nutritional Medicine, Chair of Nutritional Medicine, Technische Universität München, Freising-Weihenstephan, Germany. julia.kunath@tum.de.|Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. julia.kunath@tum.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Kunath
authors.affiliation: Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. lynne.cresswell@tum.de.
authors.forename: Lynne
authors.initials: L
authors.lastname: Stecher
authors.affiliation: ZIEL - Research Centre for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany. hans.hauner@tum.de.|Else Kröner-Fresenius-Center for Nutritional Medicine, Chair of Nutritional Medicine, Technische Universität München, Freising-Weihenstephan, Germany. hans.hauner@tum.de.|Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. hans.hauner@tum.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Hauner
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003376:Counseling; D004032:Diet; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008019:Life Style; D016015:Logistic Models; D009035:Mothers; D050177:Overweight / Q000517:prevention & control*; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D039401:Prenatal Nutritional Physiological Phenomena; D015430:Weight Gain