Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-19T02:07:42.947Z Has data issue: false hasContentIssue false
  • English
  • Français

Feasibility of conducting an early pregnancy diet and lifestyle e-health intervention: the Pregnancy Lifestyle Activity Nutrition (PLAN) project

Published online by Cambridge University Press:  08 August 2019

Rae-Chi Huang Open the ORCID record for Rae-Chi Huang [Opens in a new window] ,
Desiree Silva ,
Lawrie Beilin ,
Cliff Neppe ,
Katherine E. Mackie ,
Emma Roffey ,
Lisa Y. Gibson ,
Nina D’Vaz ,
Hayley Christian  and
Christopher M. Reid
...Show all authors
Rae-Chi Huang*
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Desiree Silva
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
Lawrie Beilin
Affiliation:
Medical School, The University of Western Australia, Crawley, Western Australia, Australia
Cliff Neppe
Affiliation:
Joondalup Health Campus, Shenton Ave, Joondalup, Western Australia, Australia
Katherine E. Mackie
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Emma Roffey
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Lisa Y. Gibson
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Nina D’Vaz
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Hayley Christian
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
Christopher M. Reid
Affiliation:
School of Public Health, Curtin University, Perth, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Susan L. Prescott
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
*
Address for correspondence: Rae-Chi Huang, The ORIGINS Project, Telethon Kids Institute, Nedlands, Western Australia, Australia. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Childhood obesity is a global issue. Excessive weight gain in early pregnancy is independently associated with obesity in the next generation. Given the uptake of e-health, our primary aim was to pilot the feasibility of an e-health intervention, starting in the first trimester, to promote healthy lifestyle and prevent excess weight gain in early pregnancy. Methods: Women were recruited between 8 and 11 weeks gestation and randomised to the intervention or routine antenatal care. The intervention involved an e-health program providing diet, physical activity and well-being advice over 12 weeks.

Results:

Women (n = 57, 43.9% overweight/obese) were recruited at 9.38 ± 1.12 (control) and 9.06 ± 1.29 (intervention) weeks’ gestation, mainly from obstetric private practices (81.2%). Retention was 73.7% for the 12-week intervention, 64.9% at birth and 55.8% at 3 months after birth.

No difference in gestational weight gain or birth size was detected. Overall treatment effect showed a mean increase in score ranking the perceived confidence of dietary change (1.2 ± 0.46, p = 0.009) and score ranking readiness to exercise (1.21 ± 0.51, p = 0.016) over the intervention. At 3 months, infants weighed less in the intervention group (5405 versus 6193 g, p = 0.008) and had a lower ponderal index (25.5 ± 3.0 versus 28.8 ± 4.0 kg/m3) compared with the control group.

Conclusion and Discussion:

A lifestyle intervention starting in the first-trimester pregnancy utilising e-health mode of delivery is feasible. Future studies need strategies to target recruitment of participants of lower socio-economic status and ensure maximal blinding. Larger trials (using technology and focused on early pregnancy) are needed to confirm if decreased infant adiposity is maintained.

Keywords

First trimesterpregnancyinterventionfeasibility
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 1 , February 2020 , pp. 58 - 70
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Vickers, MH. Developmental programming and transgenerational transmission of obesity. Ann Nutrit Metabol. 2014; 64, 26–34.CrossRefGoogle ScholarPubMed
Moodie, AR. Australia: the healthiest country by 2020. Med J Aus. 2008; 189, 588–590.CrossRefGoogle ScholarPubMed
Gaillard, R, Durmus, B, Hofman, A, Mackenbach, JP, Steegers, EAP, Jaddoe, VWV. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity. 2013; 21, 1046–1055.CrossRefGoogle ScholarPubMed
Gaillard, R, Welten, M, Oddy, WH, et al. Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic risk factors in adolescent offspring: a prospective cohort study. BJOG. 2016; 123, 207–216.CrossRefGoogle ScholarPubMed
Fraser, A, Tilling, K, Macdonald-Wallis, C, et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010; 121, 2557–U48.CrossRefGoogle Scholar
Margerison-Zilko, CE, Shrimali, BP, Eskenazi, B, Lahiff, M, Lindquist, AR, Abrams, BF. Trimester of maternal gestational weight gain and offspring body weight at birth and age five. Matern Child Health J. 2012; 16, 1215–1223.CrossRefGoogle ScholarPubMed
Rogozinska, E, Marlin, N, Jackson, L, et al. Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation. Health Technol Assess. 2017; 21, 1–158.CrossRefGoogle ScholarPubMed
Abdel-Aziz, SB, Hegazy, IS, Mohamed, DA, Abu El Kasem, MMA, Hagag, SS.Effect of dietary counseling on preventing excessive weight gain during pregnancy. Pub Health. 2018; 154, 172–181.CrossRefGoogle ScholarPubMed
Di Carlo, C, Iannotti, G, Sparice, S, et al. The role of a personalized dietary intervention in managing gestational weight gain: a prospective, controlled study in a low-risk antenatal population. Arch Gynecol Obstetr. 2014; 289, 765–770.CrossRefGoogle Scholar
Guelinckx, I, Devlieger, R, Mullie, P, Vansant, G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutrit. 2010; 91, 373–380.CrossRefGoogle ScholarPubMed
Jeffries, K, Shub, A, Walker, SP, Hiscock, R, Permezel, M. Reducing excessive weight gain in pregnancy: a randomised controlled trial. Med J Aust. 2009; 191, 429–433.CrossRefGoogle ScholarPubMed
Korpi-Hyovalti, E, Heinonen, S, Schwab, U, Laaksonen, DE, Niskanen, L. Effect of intensive counselling on physical activity in pregnant women at high risk for gestational diabetes mellitus. A clinical study in primary care. Prim Care Diabetes. 2012; 6, 261–268.CrossRefGoogle ScholarPubMed
Krukowski, RA, West, D, DiCarlo, M, et al. A behavioral intervention to reduce excessive gestational weight gain. Matern Child Health J. 2017; 21, 485–491.CrossRefGoogle ScholarPubMed
Luoto, R, Kinnunen, TI, Aittasalo, M, et al. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial. PLoS Med. 2011; 8.CrossRefGoogle Scholar
Rauh, K, Gabriel, E, Kerschbaum, E, et al. Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial. BMC Pregnancy Childbirth 2013; 13.CrossRefGoogle Scholar
Ronnberg, AK, Ostlund, I, Fadl, H, Gottvall, T, Nilsson, K. Intervention during pregnancy to reduce excessive gestational weight gain-a randomised controlled trial. BJOG 2015; 122, 537–544.CrossRefGoogle ScholarPubMed
Ruiz, JR, Perales, M, Pelaez, M, Lopez, C, Lucia, A, Barakat, R. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc. 2013; 88, 1388–1397.CrossRefGoogle ScholarPubMed
Wang, C, Wei, YM, Zhang, XM, et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol. 2017; 216, 340–351.CrossRefGoogle ScholarPubMed
Haby, K, Berg, M, Gyllensten, H, Hanas, R, Premberg, Å. Mighty mums–a lifestyle intervention at primary care level reduces gestational weight gain in women with obesity. BMC Obes. 2018; 5, 16.CrossRefGoogle ScholarPubMed
Thomas, JG, Bond, DS, Raynor, HA, Papandonatos, GD, Wing, RR. Comparison of smartphone-based behavioral obesity treatment with gold standard group treatment and control: a randomized trial. Obesity (Silver Spring, Md) 2019; 27, 572–580.CrossRefGoogle ScholarPubMed
Chan, KL, Chen, MT. Effects of social media and mobile health apps on pregnancy care: meta-analysis. Jmir Mhealth Uhealth. 2019; 7, 13.CrossRefGoogle ScholarPubMed
Bovend’Eerdt, TJ, Botell, RE, Wade, DT. Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clin Rehabil. 2009; 23, 352–361.CrossRefGoogle ScholarPubMed
Michie, S, Wood, CE, Johnston, M, Abraham, C, Francis, JJ, Hardeman, W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. 2015; 19, 1–188.CrossRefGoogle Scholar
Hill, B, Skouteris, H, Fuller-Tyszkiewicz, M, Kothe, EJ, McPhie, S. A path model of psychosocial and health behaviour change predictors of excessive gestational weight gain. J Reprod Infant Psychol. 2016; 34, 139–161.CrossRefGoogle Scholar
Mason, P, Butler, CC. Health Behavior Change: A Guide for Practitioners, 2nd edn, 2010. Churchill Livingstone Elsevier, London.Google Scholar
Webster, J, Nicholas, C, Velacott, C, Cridland, N, Fawcett, L. Validation of the WHOQOL-BREF among women following childbirth. Aus New Zealand J Obstetr Gynaecol. 2010; 50, 132–137.CrossRefGoogle ScholarPubMed
Nybo Andersen, AM, Wohlfahrt, J, Christens, P, Olsen, J, Melbye, M. Maternal age and fetal loss: population based register linkage study. BMJ 2000; 320, 1708–1712.CrossRefGoogle ScholarPubMed
Risch, HA, Weiss, NS, Clarke, EA, Miller, AB. Risk factors for spontaneous abortion and its recurrence. Am J Epidemiol. 1988; 128, 420–430.CrossRefGoogle ScholarPubMed
Chaudhry, B, Wang, J, Wu, SY, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Internal Med. 2006; 144, 742–752.CrossRefGoogle ScholarPubMed
Head, KJ, Noar, SM, Iannarino, NT, Harrington, NG. Efficacy of text messaging-based interventions for health promotion: a meta-analysis. Soc Sci Med. 2013; 97, 41–48.CrossRefGoogle ScholarPubMed
O’Brien, OA, McCarthy, M, Gibney, ER, McAuliffe, FM. Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review. Eur J Clin Nutrit. 2014; 68, 760–766.CrossRefGoogle ScholarPubMed
Soltani, H, Duxbury, AMS, Arden, MA, Dearden, A, Furness, PJ, Garland, C. Maternal obesity management using mobile technology: a feasibility study to evaluate a text messaging based complex intervention during pregnancy. J Obes. 2015, 10.CrossRefGoogle Scholar
Knight-Agarwal, C, Davis, DL, Williams, L, Davey, R, Cox, R, Clarke, A. Development and pilot testing of the eating4two mobile phone app to monitor gestational weight gain. Jmir Mhealth Uhealth. 2015; 3.CrossRefGoogle Scholar
Willcox, JC, Wilkinson, SA, Lappas, M, et al. A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial. BJOG 2017; 124, 1718–1728.CrossRefGoogle Scholar
Herring, SJ, Cruice, JF, Bennett, GG, Rose, MZ, Davey, A, Foster, GD. Preventing excessive gestational weight gain among African American women: a randomized clinical trial. Obesity 2016; 24, 30–36.CrossRefGoogle ScholarPubMed
Poston, L, Bell, R, Croker, H, et al. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2015; 3, 767–777.CrossRefGoogle ScholarPubMed
Garnaes, KK, Morkved, S, Salvesen, KA, Salvesen, O, Moholdt, T. Exercise training during pregnancy reduces circulating insulin levels in overweight/obese women postpartum: secondary analysis of a randomised controlled trial (the ETIP trial). BMC Pregnancy Childbirth. 2018; 18.CrossRefGoogle Scholar
Callaway, LK, Prins, JB, Chang, AM, McIntyre, HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006; 184, 56–59.CrossRefGoogle Scholar
Gaillard, R, Felix, JF, Duijts, L, Jaddoe, VWV. Childhood consequences of maternal obesity and excessive weight gain during pregnancy. Acta Obstet Gynecol Scand. 2014; 93, 1085–1089.CrossRefGoogle ScholarPubMed
Willcox, JC, Ball, K, Campbell, KJ, Crawford, DA, Wilkinson, SA. Correlates of pregnant women’s gestational weight gain knowledge. Midwifery. 2017; 49, 32–39.CrossRefGoogle ScholarPubMed
Shub, A, Huning, EY, Campbell, KJ, McCarthy, EA. Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Res Notes. 2013; 6, 278.CrossRefGoogle ScholarPubMed
Bookari, K, Yeatman, H, Williamson, M. Australian pregnant women’s awareness of gestational weight gain and dietary guidelines: opportunity for action. J Pregnancy. 2016; 2016, 8162645.CrossRefGoogle Scholar
Hyland, ME. Motivation and placebos: do different mechanisms occur in different contexts? Philos Trans Royal Soc B: Biol Sci. 2011; 366, 1828–1837.CrossRefGoogle ScholarPubMed
Toledano, MB, Smith, RB, Brook, JP, Douglass, M, Elliott, P. How to establish and follow up a large prospective cohort study in the 21st Century–lessons from UK COSMOS. PLoS One. 2015; 10.CrossRefGoogle Scholar
Dodd, JM, Turnbull, D, McPhee, AJ, et al. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 2014; 348, g1285.CrossRefGoogle ScholarPubMed
Supplementary material: File

Huang et al. supplementary material

Huang et al. supplementary material
Download Huang et al. supplementary material(File)
File 174.3 KB