Interventions given during pregnancy improve outcome for obese women

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The incidence of maternal obesity is on the rise, with one in five pregnant women estimated to be obese. This poses great risk for both mother and baby; obese women are more likely to develop gestational diabetes and gestational hypertension than mothers of normal weight, and pregnant women with extreme obesity are at 1.6 times greater risk of suffering a premature birth. Maternal obesity is also associated with  increased risk of miscarriage, congenital abnormalities and long-term health risks for the baby, including autism and obesity in future generations.


The National Institute for Health and Clinical Excellence (NICE) has issued guidance recommending that healthcare professionals educate women on the health risks of obesity during pregnancy. Guidance is mainly focused on weight loss when planning a pregnancy, and it is recommended that women have a balanced diet combined with an active lifestyle. However, around 50% of pregnancies are unplanned, highlighting the importance of weight-loss interventions during pregnancy.


In a systematic review and meta-analysis published in BMC Medicine, Oteng-Ntim and colleagues show that lifestyle interventions during pregnancy are associated with improved pregnancy outcome. The study analysed published randomised controlled trials (RCTs) and non-RCTs including individual and group-based dietary and exercise interventions. The authors found that interventions are associated with a reduction in maternal weight gain and prevalence of gestational diabetes, suggesting that interventions during pregnancy are beneficial. However, there were no significant effects on other outcomes, including caesarean delivery and birth weight. 


The study by Oteng-Ntim and colleagues shows that lifestyle interventions during pregnancy can be used to reduce adverse maternal outcomes, and highlights that more high-quality trials are needed to assess the effect on infant
outcomes.  Following this insightful study, future research should address whether following diet and exercise recommendations during pregnancy reduces birth weight and caesarean delivery; Oteng-Ntim and colleagues showed that studies investigating these outcomes were of low quality. If future research yields positive results, interventions targeting obesity in pregnant women could be offered routinely to improve both maternal and infant pregnancy outcomes.

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paul whiteley

Many thanks, an interesting post.

I would however perhaps advise some caution with regards to the recently suggested link between maternal obesity/metabolic conditions and autism as per the recent report from Krakowiak and colleagues: http://pediatrics.aappublications.org/content/early/2012/04/04/peds.2011-2583.abstract

It is all too easy to cloud ‘association’ with ‘causation’ as some other commentators have, particularly when faced with two issues – autism and obesity – which are showing increased numbers of cases, as for example, per the recent CDC estimates of autism in 8 year olds in the US: http://www.cdc.gov/media/releases/2012/p0329_autism_disorder.html

Autism is a very heterogeneous condition – most likely a constellation of conditions with common patterns of behaviour – complicated by an elevated risk of various comorbidities also presenting.

Whilst great efforts are being put into deciphering underlying aetiology, at the moment speculations on risk factors abound but hard facts on causation are sadly lacking.

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