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Participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain: a systematic review and meta-analysis

Grieger, J.A. ; Franks, P.W. LU ; Gomez, M.F. LU orcid ; Pomares-Millan, H. LU orcid ; Fitipaldi, H. LU ; Dudenhöffer-Pfeifer, M. LU ; Ahmad, A. LU orcid and Lim, Siew (2025) In Communications medicine 5(1).
Abstract
Background: Precision prevention involves tailoring interventions to the unique characteristics of a group or individual to maximize their effectiveness. In this study, we examined the role of participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain (GWG). Methods: We searched Medline, Embase, and PubMed, from inception up to March 2025, to identify randomized and non-randomized controlled trials of lifestyle interventions (diet, physical activity, or combined) commencing before or during pregnancy. Participant characteristics, including age, race/ethnicity, body mass index (BMI), employment status, fasting low- and high-density lipoprotein cholesterol (HDL-C) were assessed. Mean... (More)
Background: Precision prevention involves tailoring interventions to the unique characteristics of a group or individual to maximize their effectiveness. In this study, we examined the role of participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain (GWG). Methods: We searched Medline, Embase, and PubMed, from inception up to March 2025, to identify randomized and non-randomized controlled trials of lifestyle interventions (diet, physical activity, or combined) commencing before or during pregnancy. Participant characteristics, including age, race/ethnicity, body mass index (BMI), employment status, fasting low- and high-density lipoprotein cholesterol (HDL-C) were assessed. Mean differences (MD) in GWG were pooled using the random-effect model. Meta-regression and subgroup analysis were conducted by participant characteristics (e.g., BMI). Results: A total of 86 studies with 28,270 participants were included in this systematic review and meta-analysis. All lifestyle intervention types significantly reduced GWG. Combined lifestyle interventions initiated at first (MD −0.68; 95% confidence interval [CI]: −1.28, −0.07) and early second (13–17 weeks) trimester (MD −0.83; 95% CI: −1.46, −0.20) provide better effectiveness in optimizing GWG. Diet-only interventions significantly reduced GWG only in participants with normal BMI (MD −1.33 kg; CI: −1.75, −1.91) compared to the other BMI categories. Combined diet and physical activity interventions reduce excessive GWG in women with higher baseline HDL-C (β −0.04; 95% CI −0.06, −0.01). Conclusions: Lifestyle interventions reduced excessive GWG, with possible differential effects by intervention initiation time, BMI, and HDL-C. Future studies should consider physiological as well as social characteristics, in line with a holistic framework for precision medicine. © The Author(s) 2025. (Less)
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Contribution to journal
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published
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Communications medicine
volume
5
issue
1
article number
439
publisher
Nature Publishing Group
external identifiers
  • scopus:105021016259
ISSN
2730-664X
DOI
10.1038/s43856-025-01049-5
language
English
LU publication?
yes
id
a3916840-e3a5-4787-a66f-23b83ff15efd
date added to LUP
2026-04-07 11:05:02
date last changed
2026-04-08 03:15:08
@article{a3916840-e3a5-4787-a66f-23b83ff15efd,
  abstract     = {{Background: Precision prevention involves tailoring interventions to the unique characteristics of a group or individual to maximize their effectiveness. In this study, we examined the role of participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain (GWG). Methods: We searched Medline, Embase, and PubMed, from inception up to March 2025, to identify randomized and non-randomized controlled trials of lifestyle interventions (diet, physical activity, or combined) commencing before or during pregnancy. Participant characteristics, including age, race/ethnicity, body mass index (BMI), employment status, fasting low- and high-density lipoprotein cholesterol (HDL-C) were assessed. Mean differences (MD) in GWG were pooled using the random-effect model. Meta-regression and subgroup analysis were conducted by participant characteristics (e.g., BMI). Results: A total of 86 studies with 28,270 participants were included in this systematic review and meta-analysis. All lifestyle intervention types significantly reduced GWG. Combined lifestyle interventions initiated at first (MD −0.68; 95% confidence interval [CI]: −1.28, −0.07) and early second (13–17 weeks) trimester (MD −0.83; 95% CI: −1.46, −0.20) provide better effectiveness in optimizing GWG. Diet-only interventions significantly reduced GWG only in participants with normal BMI (MD −1.33 kg; CI: −1.75, −1.91) compared to the other BMI categories. Combined diet and physical activity interventions reduce excessive GWG in women with higher baseline HDL-C (β −0.04; 95% CI −0.06, −0.01). Conclusions: Lifestyle interventions reduced excessive GWG, with possible differential effects by intervention initiation time, BMI, and HDL-C. Future studies should consider physiological as well as social characteristics, in line with a holistic framework for precision medicine. © The Author(s) 2025.}},
  author       = {{Grieger, J.A. and Franks, P.W. and Gomez, M.F. and Pomares-Millan, H. and Fitipaldi, H. and Dudenhöffer-Pfeifer, M. and Ahmad, A. and Lim, Siew}},
  issn         = {{2730-664X}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Communications medicine}},
  title        = {{Participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain: a systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1038/s43856-025-01049-5}},
  doi          = {{10.1038/s43856-025-01049-5}},
  volume       = {{5}},
  year         = {{2025}},
}