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Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

Redman, Leanne M. ; Drews, Kimberly L. ; Klein, Samuel ; Horn, Linda Van ; Wing, Rena R. ; Pi-Sunyer, Xavier ; Evans, Mary ; Joshipura, Kaumudi ; Arteaga, S. Sonia and Cahill, Alison G. , et al. (2021) In Diabetes Research and Clinical Practice 171.
Abstract

Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ±... (More)

Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.

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type
Contribution to journal
publication status
published
subject
keywords
Clinical trials, Gestational diabetes mellitus, Lifestyle modification
in
Diabetes Research and Clinical Practice
volume
171
article number
108549
publisher
Elsevier
external identifiers
  • scopus:85097716535
  • pmid:33238176
ISSN
0168-8227
DOI
10.1016/j.diabres.2020.108549
language
English
LU publication?
yes
id
fbd2f2f4-3e4b-4dbe-87b0-2c6f36d923e5
date added to LUP
2021-01-05 09:26:22
date last changed
2024-04-17 22:18:15
@article{fbd2f2f4-3e4b-4dbe-87b0-2c6f36d923e5,
  abstract     = {{<p>Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m<sup>2</sup> and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=&lt;0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.</p>}},
  author       = {{Redman, Leanne M. and Drews, Kimberly L. and Klein, Samuel and Horn, Linda Van and Wing, Rena R. and Pi-Sunyer, Xavier and Evans, Mary and Joshipura, Kaumudi and Arteaga, S. Sonia and Cahill, Alison G. and Clifton, Rebecca G. and Couch, Kimberly A. and Franks, Paul W. and Gallagher, Dympna and Haire-Joshu, Debra and Martin, Corby K. and Peaceman, Alan M. and Phelan, Suzanne and Thom, Elizabeth A. and Yanovski, Susan Z. and Knowler, William C.}},
  issn         = {{0168-8227}},
  keywords     = {{Clinical trials; Gestational diabetes mellitus; Lifestyle modification}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Diabetes Research and Clinical Practice}},
  title        = {{Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium}},
  url          = {{http://dx.doi.org/10.1016/j.diabres.2020.108549}},
  doi          = {{10.1016/j.diabres.2020.108549}},
  volume       = {{171}},
  year         = {{2021}},
}