title: Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial.
abstract: This study aims to determine whether the prescription of a detailed lifestyle programme in overweight/obese pregnant women influences the occurrence of gestational diabetes (GDM), and if this kind of prescription increases the adherence to a healthier lifestyle in comparison to standard care. The study was designed as a randomized controlled trial, with open allocation, enrolling women at 9-12 weeks of pregnancy with a BMI ≥ 25 kg/m2. The women assigned to the Intervention group (I = 96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations. Those assigned to the Standard Care group (SC = 95) received lifestyle advices regarding healthy nutrition and exercise. Follow-up was planned at the 16th, 20th, 28thand 36thweeks. A total of 131 women completed the study (I = 69, SC = 62). The diet adherence was higher in the I (57.9%) than in the SC (38.7%) group. GDM occurred less frequently in the I (18.8%) than in the SC (37.1%, P = 0.019) group. The adherent women from either groups showed a lower GDM rate (12.5% vs. 41.8%, P < 0.001). After correcting for confounders, the GDM rate was explained by allocation into the I group (P = 0.034) and a lower BMI category (P = 0.039). The rates of hypertension, preterm birth, induction of labour, large for gestational age babies and birthweight > 4000 g were significantly lower in I group. The incidence of small for gestational age babies was not different. These findings demonstrate that the adherence to a personalized, hypocaloric, low-glycaemic, low-saturated fat diet started early in pregnancy prevents GDM occurrence, in women with BMI ≥ 25 kg/m2.
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Petrella
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bertarini
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Pedrielli
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Neri
authors.affiliation: Mother-Infant Department, University of Modena and Reggio Emilia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchinetti
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000517:prevention & control*; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007558:Italy; D008019:Life Style; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D010349:Patient Compliance; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: diabetes; fetal growth; obesity; physical activity; pregnancy and nutrition; pregnancy outcome