Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled...

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Metabolic Health

Background:

• Maternal obesity is linked to increased neonatal risk for obesity and metabolic syndrome.
• Previous interventions targeting gestational weight gain have not reduced neonatal adiposity.
• Pre-conception lifestyle interventions may improve the in utero environment and fetal development.

Purpose of the Study:

• To evaluate the efficacy of a lifestyle intervention to reduce weight and improve maternal metabolism prior to pregnancy (LIPP) in attenuating neonatal adiposity.
• To compare the LIPP program against standard medical advice for pregnant women.

Main Methods:

• Randomized controlled trial (RCT) with overweight/class 1 obese women preparing for a subsequent pregnancy.
• Participants randomized (1:1) to LIPP or standard care, stratified by lactation status and obesity class.
• LIPP involves intensive short-term weight loss, maintenance, supervised exercise, and a low-glycemic Mediterranean diet.

Main Results:

• Primary outcomes include differences in neonatal adiposity (PEA POD) and placental mitochondrial lipid metabolism.
• Secondary outcomes assess maternal body composition, insulin sensitivity, metabolic biomarkers, and quality of life.
• Exploratory outcomes examine umbilical cord blood insulin resistance, lipid profile, and inflammation.

Conclusions:

• This RCT will provide Level 1 evidence on the effectiveness of pre-conception maternal weight loss interventions.
• Findings could inform standard obstetrical care, improving neonatal outcomes for women planning pregnancy.