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Neonatal Outcomes Following a Preconception Lifestyle Intervention in People at Risk of Gestational Diabetes:

Md Abu Jafar Sujan1,2, Hanna Skarstad1, Guro Rosvold1

  • 1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7491 Trondheim, Norway.

Nutrients
|November 13, 2025
PubMed

Insights

A preconception lifestyle intervention did not significantly reduce the risk of high birth weight (macrosomia) or affect neonatal body composition in women at risk for gestational diabetes mellitus (GDM). Further research is needed to explore effective interventions.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Health
  • Metabolic Disorders

Background:

  • Gestational diabetes mellitus (GDM) and maternal overweight/obesity are linked to adverse neonatal outcomes, including macrosomia and increased adiposity.
  • Effective interventions to mitigate these risks are crucial for improving maternal and infant health.
  • Preconception lifestyle modifications are a potential strategy to address these risks before and during pregnancy.

Purpose of the Study:

  • To evaluate the impact of a preconception lifestyle intervention on neonatal birth weight, birth-related outcomes, and body composition.
  • To assess the effectiveness of time-restricted eating and exercise training initiated before pregnancy and continued throughout gestation.
  • To determine the intervention's effect on the primary outcome of infant birth weight exceeding 4.0 kg.

Main Methods:

  • A randomized controlled trial (BEFORE THE BEGINNING) allocated 167 participants at risk for GDM to either a lifestyle intervention or a control group.
  • The intervention involved time-restricted eating (≤10 hours/day, ≥5 days/week) and exercise training (≥100 weekly PAI points).
  • Neonatal outcomes, including birth weight and body composition at birth and 6-8 weeks postpartum, were analyzed.

Main Results:

  • No significant difference was observed in the proportion of infants with birth weight > 4.0 kg between the intervention (21%) and control (28%) groups (p=0.367).
  • Mean birth weight did not differ significantly between the groups (mean difference -159.3 g, p=0.148).
  • No significant between-group differences were found for other neonatal, birth-related, or early postnatal body composition outcomes.

Conclusions:

  • This secondary analysis found no evidence that the preconception lifestyle intervention reduced the risk of macrosomia or improved neonatal body composition.
  • The intervention, combining time-restricted eating and exercise, did not demonstrate a significant effect on the studied neonatal outcomes.
  • Further investigation into preconception interventions for GDM prevention and management is warranted.

Keywords:
birth weightexercise trainingneonatal healthpreconception lifestyle interventiontime-restricted eating

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