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Professor F. A. van Assche, who contributed to this research, died on 30 July 2018, before publication of this work.
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Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity.
In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI ≥29 kg/m2 were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed.
Outcomes were available from 334 neonates. A reduction in sum of skinfolds (−1.8 mm; 95% CI −3.5, −0.2; p = 0.03), fat mass (−63 g; 95% CI −124, −2; p = 0.04), fat percentage (−1.2%; 95% CI −2.4%, −0.04%; p = 0.04) and leptin (−3.80 μg/l; 95% CI −7.15, −0.45; p = 0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (−5.79 μg/l; 95% CI −11.43, −0.14; p = 0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups.
The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated.
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UNICEF, WHO, World Bank Group (2015) Levels and trends in child malnutrition: UNICEF–WHO–World Bank Group joint child malnutrition estimates. Available from https://data.unicef.org/wp-content/uploads/2015/12/JME-2015-edition-Sept-2015_203.pdf. Accessed 30 October 2018
McDermid E (2017) HAPO FUS shows persistent ill effects of maternal diabetes. Available from https://diabetes.medicinematters.com/pregnancy/gestational-diabetes/hapo-fus-shows-persistent-ill-effects-of-maternal-diabetes/12358110. Accessed 16 Jul 2018
Sewell MF, Huston-Presley L, Super DM, Catalano P (2006) Increased neonatal fat mass, not lean body mass, is associated with maternal obesity. Am J Obstet Gynecol 195(4):1100–1103. https://doi.org/10.1016/j.ajog.2006.06.014 CrossRefPubMed
Poston L, Bell R, Briley AL et al (2017) Improving pregnancy outcome in obese women: the UK Pregnancies Better Eating and Activity randomised controlled Trial. NIHR Journals Library, Southampton
Brown J, Alwan NA, West J et al (2017) Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database Syst Rev 5:CD011970 PubMed
Poston L, Bell R, Croker H et al (2015) Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol 3(10):767–777. https://doi.org/10.1016/S2213-8587(15)00227-2 CrossRefPubMed
Jelsma JG, van Poppel MN, Galjaard S et al (2013) DALI: vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial—study protocol. BMC Pregnancy Childbirth 13(1):142. https://doi.org/10.1186/1471-2393-13-142 CrossRefPubMedPubMedCentral
Simmons D, Jelsma JG, Galjaard S et al (2015) Results from a European multicenter randomized trial of physical activity and/or healthy eating to reduce the risk of gestational diabetes mellitus: the DALI Lifestyle Pilot. Diabetes Care 38(9):1650–1656. https://doi.org/10.2337/dc15-0360 CrossRefPubMed
Simmons D, Devlieger R, van Assche A et al (2017) Effect of physical activity and/or healthy eating on GDM risk: the DALI lifestyle study. J Clin Endocrinol Metab 102(3):903–913 PubMed
Hauguel-de Mouzon S, Lepercq, Catalano P (2006) The known and unknown of leptin in pregnancy. Am J Obstet Gynecol 194(6):1537–1545. https://doi.org/10.1016/j.ajog.2005.06.064 CrossRefPubMed
World Health Organization (2013) Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. WHO/NMH/MND/13.2. World Health Organization, Geneva
Jelsma JGM, Simmons D, Gobat N et al (2017) Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned? Process evaluation of the DALI study. BMC Pregnancy Childbirth 17(1):293. https://doi.org/10.1186/s12884-017-1471-9 CrossRefPubMedPubMedCentral
Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS (2004) Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc 36(10):1750–1760. https://doi.org/10.1249/01.MSS.0000142303.49306.0D CrossRefPubMed
Simmons D, Mandell C, Fleming C, Gatland B, Leakehe L (1994) Evaluation of a diabetes knowledge and behaviour (DKB) questionnaire. Asia Pac J Clin Nutr 3(4):193–200 PubMed
Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford, New York
Catalano PM, Mele L, Landon MB et al (2014) Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth? Am J Obstet Gynecol 211(2):137.e1–137.e7. https://doi.org/10.1016/j.ajog.2014.02.004 CrossRef
Donnelly JM, Walsh JM, Byrne J, Molloy EJ, McAuliffe FM (2015) Impact of maternal diet on neonatal anthropometry: a randomized controlled trial. Pediatr Obes 10(1):52–56. https://doi.org/10.1111/j.2047-6310.2013.00216.x CrossRefPubMed
Sauder KA, Kaar JL, Starling AP, Ringham BM, Glueck DH, Dabelea D (2017) Predictors of infant body composition at 5 months of age: the Healthy Start Study. J Pediatr 183:94–9.e1. https://doi.org/10.1016/j.jpeds.2017.01.014 CrossRefPubMedPubMedCentral
Hull HR, Thornton JC, Ji Y et al (2011) Higher infant body fat with excessive gestational weight gain in overweight women. Am J Obstet Gynecol 205(3):211.e1–211.e7. https://doi.org/10.1016/j.ajog.2011.04.004 CrossRef
HAPO Study Cooperative Research Group, Metzger BE, Lowe LP et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002 CrossRef
Nayak M, Peinhaupt M, Heinemann A et al (2016) Sedentary behavior in obese pregnant women is associated with inflammatory markers and lipid profile but not with glucose metabolism. Cytokine 88:91–98. https://doi.org/10.1016/j.cyto.2016.08.031 CrossRefPubMed
- A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial
Mireille N. M. van Poppel
F. Andre van Assche
Juan M. Adelantado
Elisabeth R. Mathiesen
Dorte M. Jensen
Maria G. Dalfra
Frank J. Snoek
Judith G. M. Jelsma
- Springer Berlin Heidelberg
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