The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial

Dodd, Jodie M., McPhee, Andrew J., Turnbull, Deborah, Yelland, Lisa N., Deussen, Andrea R., Grivell, Rosalie M., Crowther, Caroline A., Wittert, Gary, Owens, Julie A., Robinson, Jeffrey S. and LIMIT Randomised Trial Group 2014, The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial, BMC medicine, vol. 12, pp. 1-9, doi: 10.1186/s12916-014-0163-9.

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Title The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial
Author(s) Dodd, Jodie M.
McPhee, Andrew J.
Turnbull, Deborah
Yelland, Lisa N.
Deussen, Andrea R.
Grivell, Rosalie M.
Crowther, Caroline A.
Wittert, Gary
Owens, Julie A.ORCID iD for Owens, Julie A. orcid.org/0000-0002-7498-1353
Robinson, Jeffrey S.
LIMIT Randomised Trial Group
Journal name BMC medicine
Volume number 12
Article ID 163
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2014-10-13
ISSN 1741-7015
Keyword(s) Adult
Australia
Diet
Exercise
Female
Humans
Infant, Newborn
Length of Stay
Life Style
Male
New Zealand
Obesity
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Prenatal Care
Risk Reduction Behavior
Treatment Outcome
LIMIT Randomised Trial Group
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Overweight and obesity
Neonatal health
Randomised trial
Dietary and lifestyle intervention
BODY-MASS INDEX
GESTATIONAL WEIGHT-GAIN
CHILDHOOD OBESITY
MATERNAL WEIGHT
PREGNANT-WOMEN
INTERVENTIONS
INFLAMMATION
METAANALYSIS
PREVALENCE
OBSTETRICS
Summary BACKGROUND: Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese. METHODS: We report a range of pre-specified secondary neonatal outcomes from a large randomised trial in which antenatal dietary and lifestyle advice was provided to women who were overweight or obese. Pregnant women were eligible for participation with a body mass index of 25 kg/m(2) or over, and singleton gestation between 10(+0) and 20(+0) weeks. Outcome measures included gestational age at birth; Apgar score below 7 at 5 minutes of age; need for resuscitation at birth; birth weight above 4.5 kg or below 2.5 kg; birth weight, length and head circumference (and Z-scores); admission to the nursery; respiratory distress syndrome; and postnatal length of stay. Data relating to the primary outcome (large for gestational age infants defined as birth weight above the 90th centile) and birth weight above 4 kg have been reported previously. Analyses used intention-to-treat principles. RESULTS: In total, 2,142 infants were included in the analyses. Infants born to women following lifestyle advice were significantly less likely to have birth weight above 4.5 kg (2.15% versus 3.69%; adjusted risk ratio (aRR)=0.59; 95% confidence interval (CI) 0.36 to 0.98; P=0.04), or respiratory distress syndrome (1.22% versus 2.57%; aRR=0.47; 95% CI 0.24 to 0.90; P=0.02), particularly moderate or severe disease, and had a shorter length of postnatal hospital stay (3.94±7.26 days versus 4.41±9.87 days; adjusted ratio of means 0.89; 95% CI 0.82 to 0.97; P=0.006) compared with infants born to women who received Standard Care. CONCLUSIONS: For women who are overweight or obese, antenatal dietary and lifestyle advice has health benefits for infants, without an increase in the risk of harm. Continued follow-up into childhood will be important to assess the longer-term effects of a reduction in high infant birth weight on risk of child obesity. Please see related articles: http://www.biomedcentral.com/1741-7015/12/161 and http://www.biomedcentral.com/1741-7015/12/201 . CLINICAL TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ( ACTRN12607000161426 ).
Language eng
DOI 10.1186/s12916-014-0163-9
Field of Research 11 Medical And Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2014 Dodd et al.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30116331

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