Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

International Weight Management in Pregnancy (i-WIP) Collaborative Group and Owens, Julie 2017, Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials, BMJ, vol. 358, pp. 1-18, doi: 10.1136/bmj.j3119.

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Title Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials
Author(s) International Weight Management in Pregnancy (i-WIP) Collaborative Group
Owens, JulieORCID iD for Owens, Julie orcid.org/0000-0002-7498-1353
Journal name BMJ
Volume number 358
Start page 1
End page 18
Total pages 18
Publisher BMJ
Place of publication London, Eng.
Publication date 2017-07-19
ISSN 1756-1833
Keyword(s) Diet
Exercise Therapy
Female
Humans
Obesity
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Randomized Controlled Trials as Topic
Weight Gain
International Weight Management in Pregnancy (i-WIP) Collaborative Group
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
LIFE-STYLE INTERVENTION
AFRICAN-AMERICAN WOMEN
QUALITY-OF-LIFE
LOW-BACK-PAIN
DIABETES-MELLITUS
REGULAR EXERCISE
CLINICAL-TRIAL
OBESE WOMEN
HIGH-RISK
BEHAVIORAL INTERVENTION
Summary Objective To synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women's body mass index, age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications.Design Systematic review and meta-analysis of individual participant data (IPD). Data sources Major electronic databases from inception to February 2017 without language restrictions.Eligibility criteria for selecting studies Randomised trials on diet and physical activity based interventions in pregnancy.Data synthesis Statistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall, and in subgroups (interactions).Results IPD were obtained from 36 randomised trials (12 526 women). Less weight gain occurred in the intervention group than control group (mean difference -0.70 kg, 95% confidence interval -0.92 to -0.48 kg, I2=14.1%; 33 studies, 9320 women). Although summary effect estimates favoured the intervention, the reductions in maternal (odds ratio 0.90, 95% confidence interval 0.79 to 1.03, I2=26.7%; 24 studies, 8852 women) and offspring (0.94, 0.83 to 1.08, I2=0%; 18 studies, 7981 women) composite outcomes were not statistically significant. No evidence was found of differential intervention effects across subgroups, for either gestational weight gain or composite outcomes. There was strong evidence that interventions reduced the odds of caesarean section (0.91, 0.83 to 0.99, I2=0%; 32 studies, 11 410 women), but not for other individual complications in IPD meta-analysis. When IPD were supplemented with study level data from studies that did not provide IPD, the overall effect was similar, with stronger evidence of benefit for gestational diabetes (0.76, 0.65 to 0.89, I2=36.8%; 59 studies, 16 885 women).Conclusion Diet and physical activity based interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. There is no evidence that effects differ across subgroups of women.
Notes This article has a correction. Please see: https://www.bmj.com/content/358/bmj.j3991
Language eng
DOI 10.1136/bmj.j3119
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2017, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30116639

Document type: Journal Article
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