Effect of a Pregnancy Lifestyle Intervention Embedded Into a Home Visiting Program on Child Neurodevelopment

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Public Health

Background:

• Maternal obesity is a known risk factor for adverse child neurodevelopmental outcomes.
• Home visiting programs can support maternal and child health.
• Targeting gestational weight gain is crucial for mitigating risks associated with maternal obesity.

Purpose of the Study:

• To evaluate the impact of a lifestyle weight management intervention integrated into the Parents as Teachers (PAT) home visiting program on infant neurodevelopment at 18 months.
• To assess cognitive, language, and motor development in offspring of mothers with obesity who received standard versus enhanced home visiting services.
• To explore the relationship between intervention intensity (number of visits) and neurodevelopmental outcomes.

Main Methods:

• Randomized controlled trial involving pregnant women (BMI 25.0-45.0 kg/m², 18-45 years) randomized to standard PAT or PAT with lifestyle weight management (PAT+).
• Intervention delivered from early pregnancy to 12 months postpartum.
• Neurodevelopment assessed at 18 months using the Bayley III Scales of Infant Development; data analyzed with t-tests and ANCOVA.

Main Results:

• No significant differences in cognitive, language, or motor composite scores were observed between the PAT and PAT+ groups at 18 months.
• A positive correlation was found between the number of PAT visits and cognitive and language scores across both groups.
• Gestational weight gain was reduced in the intervention group, but this did not translate to improved neurodevelopmental outcomes.

Conclusions:

• A lifestyle weight management program integrated into a home visiting service did not alter offspring neurodevelopmental trajectories at 18 months, despite reducing gestational weight gain.
• The findings suggest that while lifestyle interventions may impact maternal weight during pregnancy, their effect on early child neurodevelopment in this population requires further investigation.
• Increased engagement with home visiting services (more visits) showed a positive association with cognitive and language development, highlighting the potential benefit of program participation.