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Published on: April 19, 2024
Effects of maternal lifestyle interventions on child neurobehavioral development: Follow-up of randomized controlled
Malou D Menting1,2,3,4, Cornelieke van de Beek1,2, Kristiina Rono5
1Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, the Netherlands.
Insights
Maternal lifestyle interventions for obese women before and during pregnancy did not significantly impact child neurobehavioral development or behavioral problems. Further research is needed to detect subtle developmental differences.
Area of Science:
- Public Health
- Maternal-Child Health
- Developmental Psychology
Background:
- Obesity in pregnant women poses risks for child neurodevelopmental issues.
- The impact of pre- and during-pregnancy lifestyle interventions on offspring neurobehavior is not well-established.
Purpose of the Study:
- To evaluate the effect of a maternal lifestyle intervention on child neurobehavioral development and behavioral problems.
- To analyze follow-up data from randomized controlled trials (Finnish RADIEL and Dutch LIFEstyle).
Main Methods:
- Recruited obese women (BMI ≥29 kg/m²) before or early in pregnancy.
- Assigned participants to either a lifestyle intervention or standard care.
- Assessed child neurodevelopment and behavior at ages 3-6 years using validated questionnaires.
Main Results:
- No significant differences in child neurodevelopmental scores between intervention and control groups (RADIEL & LIFEstyle).
- Child behavioral problem scores also showed no significant differences between groups.
- The study lacked sufficient sample size to detect subtle neurobehavioral differences.
Conclusions:
- Maternal lifestyle interventions before or during pregnancy in obese women showed no considerable effects on child neurobehavioral development.
- Detecting subtle differences in child neurodevelopment requires larger sample sizes.
- Further investigation into optimizing interventions for maternal obesity and child outcomes is warranted.
Abstract:
Obesity is a major public health problem. Children of women who were obese before or during pregnancy are at increased risk for neurobehavioral developmental problems. Whether a maternal lifestyle intervention conducted before and during pregnancy in obese women affects child neurobehavioral development is unknown. This study reports on the follow-up of a subsample of two randomized controlled trials, the Finnish RADIEL (n = 216) and Dutch LIFEstyle (n = 305) trial. Women with a pre-pregnancy BMI ≥29 kg/m2 wishing to conceive or who were already pregnant (<20 weeks) were allocated to a lifestyle intervention or to care as usual. Child neurodevelopment was measured with the Ages and Stages Questionnaire and child behavioral problems were measured with the Childhood Behavior Checklist (RADIEL) or the Strengths and Difficulties Questionnaire (LIFEstyle) at age 3-6 years. We used linear and binary logistic regression analyses to assess the effects of the lifestyle interventions on children's neurobehavioral developmental scores. Follow-up data was available from 161(38%) RADIEL and 96(32%) LIFEstyle children. Child neurodevelopmental scores did not differ significantly between children in the intervention and the control group (RADIEL:median = 275 vs. 280; LIFEstyle:median = 270 vs 267). Child behavioral problem scores did not differ significantly between children in the intervention and the control group (RADIEL:median = 22 vs. 21; LIFEstyle:median = 8 vs. 8). We did not observe considerable effects of the lifestyle interventions before or during pregnancy in obese women on child neurobehavioral development. With our sample sizes, we were not able to detect subtle differences in neurobehavioral development however.
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