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Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy

Lookup NU author(s): Dr Louise Hayes, Dr Ruth Bell, Professor Stephen Robson, Dr Naweed Sattar

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Abstract

© 2017 Macmillan Publishers Limited, part of Springer Nature. Randomised controlled trials are required to address causality in the reported associations between maternal influences and offspring adiposity. The aim of this study was to determine whether an antenatal lifestyle intervention, associated with improvements in maternal diet and reduced gestational weight gain (GWG) in obese pregnant women leads to a reduction in infant adiposity and sustained improvements in maternal lifestyle behaviours at 6 months postpartum. SUBJECTS AND METHODS: We conducted a planned postnatal follow-up of a randomised controlled trial (UK Pregnancies Better Eating and Activity Trial (UPBEAT)) of a complex behavioural intervention targeting maternal diet (glycaemic load (GL) and saturated fat intake) and physical activity in 1555 obese pregnant women. The main outcome measure was infant adiposity, assessed by subscapular and triceps skinfold thicknesses. Maternal diet and physical activity, indices of the familial lifestyle environment, were assessed by questionnaire. RESULTS: A total of 698 (45.9%) infants (342 intervention and 356 standard antenatal care) were followed up at a mean age of 5.92 months. There was no difference in triceps skinfold thickness z-scores between the intervention vs standard care arms (difference-0.14 s.d., 95% confidence interval-0.38 to 0.10, P = 0.246), but subscapular skinfold thickness z-score was 0.26 s.d. (-0.49 to-0.02; P = 0.03) lower in the intervention arm. Maternal dietary GL (-35.34;-48.0 to-22.67; Po0.001) and saturated fat intake (-1.93% energy;-2.64 to-1.22; P<0.001) were reduced in the intervention arm at 6 months postpartum. Causal mediation analysis suggested that lower infant subscapular skinfold thickness was partially mediated by changes in antenatal maternal diet and GWG rather than postnatal diet. CONCLUSIONS: This study provides evidence from follow-up of a randomised controlled trial that a maternal behavioural intervention in obese pregnant women has the potential to reduce infant adiposity and to produce a sustained improvement in maternal diet at 6 months postpartum.


Publication metadata

Author(s): Patel N, Godfrey KM, Pasupathy D, Levin J, Flynn AC, Hayes L, Briley AL, Bell R, Lawlor DA, Oteng-Ntim E, Nelson SM, Robson SC, Sattar N, Singh C, Wardle J, White SL, Seed PT, Poston L, on behalf of the UPBEAT Consortium

Publication type: Article

Publication status: Published

Journal: International Journal of Obesity

Year: 2017

Volume: 41

Issue: 7

Pages: 1018-1026

Print publication date: 01/07/2017

Online publication date: 20/02/2017

Acceptance date: 31/01/2017

ISSN (print): 0307-0565

ISSN (electronic): 1476-5497

Publisher: Nature Publishing Group

URL: https://doi.org/10.1038/ijo.2017.44

DOI: 10.1038/ijo.2017.44


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