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Paul Franks

Paul Franks

Principal investigator

Paul Franks

One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials

Author

  • Suzanne Phelan
  • Rebecca G. Clifton
  • Debra Haire-Joshu
  • Leanne M. Redman
  • Linda Van Horn
  • Mary Evans
  • Kaumudi Joshipura
  • Kimberly L. Drews
  • S. Sonia Arteaga
  • Alison G. Cahill
  • Kimberly L. Drews
  • Paul W. Franks
  • Dympna Gallagher
  • Jami L. Josefson
  • Samuel Klein
  • William C. Knowler
  • Corby K. Martin
  • Alan M. Peaceman
  • Elizabeth A. Thom
  • Rena R. Wing
  • Susan Z. Yanovski
  • Xavier Pi-Sunyer

Summary, in English

Background/objectives: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. Subjects/methods: In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. Results: Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of −1.6 kg (95% CI −2.5, −0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. Conclusions: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.

Department/s

  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2020

Language

English

Pages

57-68

Publication/Series

International Journal of Obesity

Volume

44

Document type

Journal article

Publisher

Nature Publishing Group

Topic

  • Obstetrics, Gynecology and Reproductive Medicine

Status

Published

Research group

  • Genetic and Molecular Epidemiology

ISBN/ISSN/Other

  • ISSN: 0307-0565