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Type: Journal article
Title: Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial
Author: Dodd, J.
Turnbull, D.
McPhee, A.
Deussen, A.
Grivell, R.
Yelland, L.
Crowther, C.
Wittert, G.
Owens, J.
Robinson, J.
Citation: BMJ, 2014; 348(3):1-12
Publisher: BMJ
Issue Date: 2014
ISSN: 1756-1833
Organisation: Robinson Institute
Statement of
Jodie M Dodd, Deborah Turnbull, Andrew J McPhee, Andrea R Deussen, Rosalie M Grivell, Lisa N Yelland, Caroline A Crowther, Gary Wittert, Julie A Owens, and Jeffrey S Robinson
Abstract: OBJECTIVE To determine the effect of antenatal dietary and lifestyle interventions on health outcomes in overweight and obese pregnant women. DESIGN Multicentre randomised trial. We utilised a central telephone randomisation server, with computer generated schedule, balanced variable blocks, and stratification for parity, body mass index (BMI) category, and hospital. SETTING Three public maternity hospitals across South Australia. PARTICIPANTS 2212 women with a singleton pregnancy, between 10+0 and 20+0 weeks’ gestation, and BMI ≥25. INTERVENTIONS 1108 women were randomised to a comprehensive dietary and lifestyle intervention delivered by research staff; 1104 were randomised to standard care and received pregnancy care according to local guidelines, which did not include such information. MAIN OUTCOME MEASURES Incidence of infants born large for gestational age (birth weight ≥90th centile for gestation and sex). Prespecified secondary outcomes included birth weight >4000 g, hypertension, pre-eclampsia, and gestational diabetes. Analyses used intention to treat principles. RESULTS 2152 women and 2142 liveborn infants were included in the analyses. The risk of the infant being large for gestational age was not significantly different in the two groups (lifestyle advice 203/1075 (19%) v standard care 224/1067 (21%); adjusted relative risk 0.90, 95% confidence interval 0.77 to 1.07; P=0.24). Infants born to women after lifestyle advice were significantly less likely to have birth weight above 4000 g (lifestyle advice 164/1075 (15%) v standard care 201/1067 (19%); 0.82, 0.68 to 0.99; number needed to treat (NNT) 28, 15 to 263; P=0.04). There were no differences in maternal pregnancy and birth outcomes between the two treatment groups. CONCLUSIONS For women who were overweight or obese, the antenatal lifestyle advice used in this study did not reduce the risk delivering a baby weighing above the 90th centile for gestational age and sex or improve maternal pregnancy and birth outcomes. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
Keywords: LIMIT Randomised Trial Group; Humans; Pregnancy Complications; Diabetes, Gestational; Fetal Macrosomia; Pre-Eclampsia; Hypertension; Obesity; Birth Weight; Pregnancy Outcome; Risk Reduction Behavior; Gestational Age; Pregnancy; Adult; Infant, Newborn; Health Promotion; Female; Male; Overweight; Weight Reduction Programs
Description: for the LIMIT Randomised Trial Group
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
RMID: 0030000161
DOI: 10.1136/bmj.g1285
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Appears in Collections:Obstetrics and Gynaecology publications

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