Improving the lifestyle of obese women during pregnancy could provide long-term cardiovascular benefits for their children—new study finds.
The study, led by King’s College London, examined how the diet and physical activity intervention in pregnant women with obesity could positively influence the health of the women and their children three years after giving birth. The result of the study is published now in the journal Pediatric Obesity (Dalrymple et al., 2020).
Observational Pregnancy Studies
Many trials have attempted to reduce weight gain or improve obesity-related pregnancy outcomes through diet and/or physical activity interventions during pregnancy (Flynn et al., 2016) (International Weight Management in Pregnancy Collaborative 2017). However, this study aimed to assess if similar interventions influence adiposity and cardiovascular function in the children born to the participant women and if improvements in mothers’ lifestyle behaviors continued.
In the study, the researchers recruited 1555 pregnant women with BMI >30, age 16, or more, across the UK. Women having pre-existence disease or multiple pregnancies were excluded from the study. All eligible participants were randomly divided into two groups.
One group was given a healthy diet and exercise intervention, while the other group received standard health care for eight months during the pregnancy. The dietary intervention included reducing carbohydrates and saturated fatty acid (SFA) rich foods. Self-reported physical activity was assessed using the International Physical Activity Questionnaire. To monitor physical activity, all participants received a pedometer. Also, they were provided a DVD having instructions for choosing suitable exercises.
Researchers conducted a follow-up examination after three years after delivery. They found that children born to the trial intervention group had a lower resting heart rate of -5 bpm than children treated with standard care. A higher resting heart rate in adults is associated with hypertension and cardiovascular dysfunction.
The study also found that mothers in the intervention group maintained a healthier diet three years after birth.
While women reported lower carbohydrates and saturated fatty acid intake and higher protein intake three years after delivery, there were no differences in self-reported physical activity or body composition measures.
“This research shows that a lifestyle intervention in pregnant women, which focused on improving diet and increasing physical activity, is associated with improved cardiovascular function in the child at three years of age and a sustained improvement in the mothers’ diet, three years after the intervention finished”—said lead author Kathryn Dalrymple.
Senior author Professor Lucilla Poston, Tommy’s Chair for Maternal and Fetal Health, said: “obesity in pregnancy is a major problem because it can increase the risk of complications in pregnancy as well as affecting the longer-term health of the child. This study strengthens my resolve to highlight just how important it is that we give children a healthy start in life.”
The researchers will follow up with these children again at 8-10 years of age to see if this improvement in cardiovascular function is maintained through childhood.
Dalrymple, K. V., F. A. S. Tydeman, et al. (2020). “Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity.” Pediatric Obesity n/a(n/a): e12725. 10.1111/ijpo.12725.
Flynn, A. C., K. Dalrymple, et al. (2016). “Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials.” Nutr Rev 74(5): 312-328. 10.1093/nutrit/nuw005.
International Weight Management in Pregnancy Collaborative, G. (2017). “Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials.” BMJ 358: j3119. 10.1136/bmj.j3119.