Abstract
Background
Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.
Objectives
This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.
Methods
In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m2 and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.
Results
Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of −54.1 g (−146.7 to 38.9 g), −84.9 g (−194.0 to 24.7 g), and −99.8 g (−227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of −185.8 g (−362.5 g to −9.2 g) versus −23.4 g (−190.4 g to 143.5 g) in females.
Conclusions
A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.
Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.
Objectives
This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.
Methods
In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m2 and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.
Results
Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of −54.1 g (−146.7 to 38.9 g), −84.9 g (−194.0 to 24.7 g), and −99.8 g (−227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of −185.8 g (−362.5 g to −9.2 g) versus −23.4 g (−190.4 g to 143.5 g) in females.
Conclusions
A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.
| Original language | English |
|---|---|
| Article number | e13199 |
| Number of pages | 12 |
| Journal | Pediatric Obesity |
| Volume | 20 |
| Issue number | 5 |
| Early online date | 19 Jan 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 19 Jan 2025 |
Bibliographical note
Publisher Copyright:© 2025 The Author(s). Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
