What characteristics of nutrition and physical activity interventions are key to effectively reducing weight gain in obese or overweight pregnant women? A systematic review and meta-analysis.
Lifestyle interventions targeting gestational weight gain (GWG) report varying degrees of success. To better understand factors influencing efficacy, we reviewed randomized trials specifically among obese and overweight pregnant women.



We conducted a systematic review and a meta-analysis of 32 studies with a pooled population of 5,869 overweight or obese pregnant women. Random effects models were fit to compute the weighted mean difference (WMD) in GWG between groups across studies. Subgroup analyses were conducted to compare intervention efficacy in overweight vs. obese pregnant women, and interventions delivered by prenatal care providers (PCPs) vs. non-PCPs during pregnancy. Moderator analyses ensured.



Nine (28%) of 32 studies reported significant reductions in GWG in response to intervention. Of these, six (66%) of nine were delivered by PCPs. Overall, the WMD in GWG was -1.71 (95% confidence interval [CI]: -2.55, -0.86) kg. However, interventions delivered by PCPs yielded a significantly greater reduction in GWG compared to interventions delivered by non-PCPs (WMD = -3.88 kg; 95% CI: -7.01, -0.75 vs. -0.80 kg; 95% CI: -1.32, -0.28; p for difference = 0.005).



When PCPs counsel nutrition and physical activity, obese and overweight pregnant women have greater success meeting GWG targets and may be more motivated to modify their behaviour than with other modes of intervention deliveries.
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
SeonAe
S
Yeo
Health Science Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Jennifer S
JS
Walker
School of Medicine, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Melissa C
MC
Caughey
Undergraduate Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Amanda M
AM
Ferraro
School of Public Health, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Josephine K
JK
Asafu-Adjei
D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D050177:Overweight / Q000150:complications / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D037841:Pregnant People / Q000523:psychology; D011295:Prenatal Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015430:Weight Gain
Behaviour intervention; diet; exercise; pregnancy; prenatal care