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Impact of an Antenatal Family-based Behavioral Treatment with a Nutrition and Exercise Lifestyle Intervention Program
Madeline E Hubbard1,2,3,4, Stephanie-May Ruchat5, Margie H Davenport6,7
1R. Samuel McLaughlin Foundation- Exercise and Pregnancy Laboratory, Western University, London, ON, Canada.
Insights
Adding family-based behavioral treatment to a lifestyle intervention program significantly reduced excessive infant weight-for-length at birth. This approach is crucial for preventing childhood overweight and obesity, particularly in mothers with pre-pregnancy obesity.
Area of Science:
- Maternal and Child Health
- Pediatric Endocrinology
- Behavioral Science
Background:
- World Health Organization (WHO) growth standards monitor infant size, with excessive weight-for-length (≥85th percentile) posing a risk for childhood overweight.
- Antenatal interventions like the nutrition and exercise lifestyle intervention program (NELIP) have shown success in preventing excessive gestational weight gain.
- Further strategies to enhance antenatal interventions are of ongoing interest.
Purpose of the Study:
- To investigate the impact of adding family-based behavioral treatment (FBBT) to NELIP on infant weight-for-length at birth.
- To assess the effect on gestational weight gain.
- To identify potential benefits for preventing future childhood overweight and obesity.
Main Methods:
- Participants were recruited into the NELIP group (n=68) and the NELIP + FBBT group (n=48).
- A subgroup of the NELIP group (n=48) was matched to the NELIP + FBBT group based on pre-pregnancy BMI, parity, and age for comparative analysis.
- Infant weight-for-length was assessed at birth using WHO growth standards.
Main Results:
- A significantly lower proportion of infants in the NELIP + FBBT group (29.2%) had weight-for-length at or above the 85th percentile compared to the matched NELIP group (50.0%).
- This difference was statistically significant (p=0.037) with a medium effect size (φc=0.213), particularly noted when considering maternal pre-pregnancy BMI.
- No significant differences were observed between the groups regarding maternal gestational weight gain.
Conclusions:
- The integration of FBBT into NELIP enhanced its effectiveness in reducing excessive infant weight-for-length at birth.
- This combined approach shows particular promise for participants with pre-pregnancy obesity.
- The findings suggest a potential strategy for mitigating future risks of childhood overweight and obesity.
Background:
World Health Organization (WHO) growth standards, including weight-for-length, are used to monitor infant size. Excessive infant weight-for-length at or above the 85th percentile is a risk for childhood overweight. Although antenatal interventions like the nutrition and exercise lifestyle intervention program (NELIP) have successfully prevented excessive gestational weight gain, strategies to improve the intervention remain of interest. This study investigated the impact of adding a family-based behavioral treatment (FBBT) to NELIP on infant weight-for-length at birth based on WHO growth standards and gestational weight gain.
Methods:
Participants were recruited for the NELIP group (n = 68), followed by the NELIP + FBBT group (n = 48). In addition to full analyses, a subgroup of NELIP (n = 48) was matched to NELIP + FBBT based on pre-pregnancy BMI, parity and age.
Results:
The number of infants with excessive weight-for-length at birth was significantly different between the NELIP + FBBT and the full NELIP group when maternal pre-pregnancy BMI was considered (φc = .275; p = .032). Significantly fewer infants had weight-for-length at or above the 85th percentile in the NELIP + FBBT group (29.2%) compared to the matched NELIP group (50.0%) with a medium effect size (φc = .213; p = .037). There were no significant differences between groups in any measures of maternal gestational weight gain.
Conclusions:
The inclusion of a FBBT improved the effectiveness of a NELIP by decreasing the prevalence of excessive infant weight-for-length at birth, especially in participants with pre-pregnancy obesity, which could have implications on future childhood overweight and obesity.
Clinicaltrials:
gov identifier: NCT01129505.
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