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Effect of a Pregnancy Lifestyle Intervention Embedded Into a Home Visiting Program on Child Neurodevelopment
Sarah S Farabi1,2,3, Rosemary Bass2, Amit Mathur4
1Office of Nursing Research, Barnes Jewish College Goldfarb School of Nursing, St. Louis, Missouri, USA.
Insights
A lifestyle intervention for pregnant women with obesity did not impact child neurodevelopment at 18 months. However, more home visits were linked to better cognitive and language skills in children.
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.
Abstract:
Maternal obesity is associated with a higher risk of abnormal child neurodevelopment. The aim of this study was to determine the effect of a lifestyle intervention embedded into a home visiting program, Parents as Teachers (PAT), on 18-month neurodevelopment in the offspring. Pregnant women (9-15 weeks) of African American Race, 18-45 years old, first-trimester BMI 25.0-45.0 kg/m2, and socioeconomically disadvantaged (e.g., Medicaid status) were randomized to standard home visiting (PAT only) or home visiting with lifestyle weight management counseling (PAT+), which began after the baseline assessment in pregnancy and continued until 12 months postpartum. Cognitive, language, and motor development at 18 months was assessed using the Bayley III Scales of Infant Development. Neurodevelopment outcomes were compared between groups and between child sex using un-paired t-tests and ANCOVA. 200 children (105 PAT+/95 PAT only) completed the neurodevelopmental testing at 18 months. Cognitive, language, and motor composite scores did not differ between groups. Across groups, number of PAT visits was positively correlated with scores in the cognitive and language domains. Our findings suggest that a lifestyle weight management program which decreased gestational weight gain does not affect offspring neurodevelopmental outcomes at 18 months. Trial Registration: ClinicalTrials.gov identifier: NCT01768793.
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