(b) Prenatal intervention studies using the 2009 IOM gestational weight gain recommendations
| Reference, Sample characteristics | Treatment | Gestational weight gain (GWG) (kg) | Maternal weight retention postpartum (PP) (kg) |
Infant birth weight (g) | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Control | Intervention | Control | Intervention | P value | Control | Intervention | P value | Control | Intervention | P value | |
|
Cavalcante et al. [70] Design RCT N = 71 C = 37 I = 24 Country Brazil Ethnicity NA Age NA Parity NA SES Low SES Prepreg BMI C = 23.4 ± 3.8 I = 24.1 ± 4.5 Gestational age at recruitment 18–20 weeks Duration of study until end of pregnancy |
Sedentary during pregnancy |
Physical activity:
Supervised exercise program Frequency 3/week Intensity 70% pred HR max Duration 50 min Type Water aerobic Delivered by trained instructors |
At delivery
15.1 ± 1.6 Adherence to IOM NA |
At delivery
14.3 ± 2.1 Adherence to IOM NA |
0.38 | NA | NA | — |
3,313 ± 656 <2,500 g n = 2 (37%) |
3,222 ± 563 <2,500 g n = 3 (33%) |
0.54 0.44 |
|
| |||||||||||
|
Barakat et al. [69] Design RCT N = 160 C = 80 I = 80 Country Spain Ethnicity: NA Age: C = 29.5 ± 3.7 I = 30.4 ± 2.9 Parity C = 57% nulliparous I = 72% nulliparous SES C = 13% high school I = 26% high school Prepreg BMI: C = 23.4 ± 0.5 I = 24.3 ± 0.5 Gestational age at recruitment 12-13 weeks Duration of study until end of pregnancy |
Continue usual daily activities |
Physical activity:
Supervised exercise program Frequency 3/week Intensity 60% HR max Duration 35–40 min Type Muscle strengthening and toning program |
At delivery
12.4 ± 3.4 Adherence to 2009 IOM NA |
At delivery
11.5 ± 3.7 Adherence to 2009 IOM NA |
>0.1 | NA | NA | — |
3,307 ± 477 <2,500 g n = 4 (6%) >4,000 g n = 7 (10%) |
3,165 ± 411 <2,500 g n = 4 (6%) >4,000 g n = 1 (1%) |
>0.1 >0.1 >0.1 |
|
| |||||||||||
|
Barakat et al. [72] Design RCT N = 83 C = 43 I = 40 Country Spain Ethnicity NA Age C = 31 ± 3 I = 32 ± 4 Parity C = 49% nulliparous I = 65% nulliparous SES C = 14% >high school I = 83% >high school Prepreg BMI: C = 23.0 ± 2.9 I = 22.7 ± 2.8 Gestational age at recruitment 6–9 weeks Duration of study until end of pregnancy |
Continue usual daily activities |
Physical activity:
Supervised exercise program Frequency 3/week Intensity ≤70% HR max Duration 35–45 min Type aerobic class (2/week) aquatic activities (1/week) |
At delivery
13.8 ± 3.1 Adherence to 2009 IOM NA |
At delivery
12.5 ± 3.2 Adherence to 2009 IOM NA |
>0.05 | NA | NA | — | 3,465 ± 411 | 3,404 ± 465 | >0.05 |
|
| |||||||||||
|
Haakstad and Bø [67] Design RCT N = 105 C = 53 I = 52 Country Norway Ethnicity NA Age C = 30.3 ± 4.4 I = 31.2 ± 3.7 Parity 100% nulliparous SES C = 85% college/university I = 85% college/university Prepreg BMI C = 23.9 ± 4.7 I = 23.8 ± 3.8 Gestational age at recruitment C = 18.0 ± 4.3 I = 17.3 ± 4.1 Duration of study 12 weeks |
Continue usual daily activities |
Physical activity:
Supervised exercise program Frequency ≥2/week Intensity 12–14 RPE Duration 60 min Type Aerobic dance Women were asked to exercise 30 min/day on other days Delivered by certified aerobic instructors |
At 36–38 weeks
13.8 ± 4.0 Adherence to 2009 IOM 62% did not exceed |
At 36–38 weeks
13.0 ± 4.0 If attendance to all ex sessions (2/week, n = 24) 11.0 ± 2.0 Adherence to 2009 IOM 67% if ex 2/week 0% did not exceed |
0.31 0.01 0.59 0.006 |
At 8.1 ± 1.5 w PP
3.3 ± 4.1 |
At 7.1 ± 1.6
we PP 3.3 ± 3.9 if ex sessions 2/week 0.8 ± 1.7 |
0.93 0.001 |
NA | NA | — |
|
| |||||||||||
|
Nascimento et al. [68] Design RCT N = 82 C = 42 I= 40 Country Brazil Ethnicity NA Age C = 30.9 ± 5.9 I = 29.7 ± 6.8 Parity C = 24% nulliparous I = 30% nulliparous SES C = 38% >12 yr of school I = 43% >12 yr of school Prepreg BMI C = 36.4 ± 6.9 I = 34.8 ± 6.6 Gestational age at recruitment C = 17.8 ± 3.7 I = 17.6 ± 4.2 Duration of study until end of pregnancy |
Standard prenatal care |
Physical activity:
Supervised exercise program Frequency 1/week Intensity HR < 140 Duration 40 min Type Aerobic dance Women were asked to exercise 5/week at home Other: women were counseled on recommended GWG Delivered by trained physical therapists |
At final visit
11.5 ± 7.4 OB = 10.9 ± 7.6 OW =16.4 ± 3.9 Adherence to 2009 IOM 43% did not exceed |
At final visit
10.3 ± 5.0 OB = 10.4 ± 5.6 OW = 10.0 ± 1.7 Adherence to 2009 IOM 52% did not exceed |
0.54 0.76 0.001 0.43 |
NA | NA | — |
3,228 ± 591 SGA n = 1 (3%) LGA n = 8 (24%) |
3,267 ± 700 SGA n = 2 (6%) LGA n = 8 (24%) |
0.79 NS NS |
Abbreviations: RCT: randomized controlled trial; N: total number; C: control group; I: intervention group; SES: socioeconomic status; prepreg BMI: body mass index prior to pregnancy; IOM: Institute of Medicine; NA: non available; NS: non significant, NW: normal weight; OW: overweight; OB: obese.