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Updated: Sep 19, 2025

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Interpregnancy and pregnancy lifestyle intervention (INTER-ACT): a randomized controlled trial.

Annick Bogaerts1, Hanne Van Uytsel2, Lieveke Ameye2

  • 1REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium; Faculty of Health, University of Plymouth, Devon, UK.

American Journal of Obstetrics and Gynecology
|June 4, 2025
PubMed
Summary

The INTER-ACT lifestyle intervention did not reduce pregnancy complications for women with prior excessive gestational weight gain. However, adherence to the program during pregnancy significantly lowered complication risks in both groups.

Keywords:
INTER-ACTapplicationcesarean sectioncomplicationdiabeteseHealthhypertensionlarge gestational agemental wellbeingnutritionphysical activitypostpartum

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Area of Science:

  • Reproductive Health
  • Maternal Health
  • Preventive Medicine

Background:

  • Preconception lifestyle interventions can mitigate pregnancy complications but face challenges in reaching women.
  • Excessive gestational weight gain is a risk factor for adverse pregnancy outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of the Interpregnancy Coaching for a Healthy Future (INTER-ACT) lifestyle intervention.
  • To assess the intervention's impact on reducing pregnancy complications in women with a history of excessive gestational weight gain.

Main Methods:

  • A prospective, multicenter randomized controlled trial involving women recruited within 6 weeks postpartum.
  • The INTER-ACT intervention included face-to-face coaching and an E-Health application focusing on nutrition, physical activity, and mental wellbeing.
  • The primary outcome was a composite of pregnancy complications; 250 women per group were needed for statistical power.

Main Results:

  • The INTER-ACT intervention did not significantly reduce the composite outcome of pregnancy complications (OR, 1.29; P=.23).
  • Post hoc analysis revealed that adherence to follow-up during pregnancy was associated with a halved risk of composite outcomes in both intervention and control groups (P=.04 and P=.02, respectively).

Conclusions:

  • The INTER-ACT intervention was not effective in lowering composite pregnancy complication rates in women with previous excessive gestational weight gain.
  • Adherence to the intervention during pregnancy emerged as a critical factor, significantly reducing complication risks.
  • Future research should prioritize improving adherence and investigating lifestyle interventions across diverse BMI ranges in the preconception and interpregnancy periods.