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Type: Journal article
Title: The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial
Author: Dodd, J.
McPhee, A.
Turnbull, D.
Yelland, L.
Deussen, A.
Grivell, R.
Crowther, C.
Wittert, G.
Owens, J.
Robinson, J.
Citation: BMC Medicine, 2014; 12(1):163-1-163-9
Publisher: BioMed Central
Issue Date: 2014
ISSN: 1741-7015
Statement of
Jodie M Dodd, Andrew J McPhee, Deborah Turnbull, Lisa N Yelland, Andrea R Deussen, Rosalie M Grivell, Caroline A Crowther, Gary Wittert, Julie A Owens, Jeffrey S Robinson, and For the LIMIT Randomised Trial Group
Abstract: BACKGROUND Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese. METHODS We report a range of pre-specified secondary neonatal outcomes from a large randomised trial in which antenatal dietary and lifestyle advice was provided to women who were overweight or obese. Pregnant women were eligible for participation with a body mass index of 25 kg/m2 or over, and singleton gestation between 10+0 and 20+0 weeks. Outcome measures included gestational age at birth; Apgar score below 7 at 5 minutes of age; need for resuscitation at birth; birth weight above 4.5 kg or below 2.5 kg; birth weight, length and head circumference (and Z-scores); admission to the nursery; respiratory distress syndrome; and postnatal length of stay. Data relating to the primary outcome (large for gestational age infants defined as birth weight above the 90th centile) and birth weight above 4 kg have been reported previously. Analyses used intention-to-treat principles. RESULTS In total, 2,142 infants were included in the analyses. Infants born to women following lifestyle advice were significantly less likely to have birth weight above 4.5 kg (2.15% versus 3.69%; adjusted risk ratio (aRR)?=?0.59; 95% confidence interval (CI) 0.36 to 0.98; P?=?0.04), or respiratory distress syndrome (1.22% versus 2.57%; aRR?=?0.47; 95% CI 0.24 to 0.90; P?=?0.02), particularly moderate or severe disease, and had a shorter length of postnatal hospital stay (3.94?±?7.26 days versus 4.41?±?9.87 days; adjusted ratio of means 0.89; 95% CI 0.82 to 0.97; P?=?0.006) compared with infants born to women who received Standard Care. CONCLUSIONS For women who are overweight or obese, antenatal dietary and lifestyle advice has health benefits for infants, without an increase in the risk of harm. Continued follow-up into childhood will be important to assess the longer-term effects of a reduction in high infant birth weight on risk of child obesity. Please see related articles: and CLINICAL TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (http://ACTRN12607000161426)
Keywords: Pregnancy; Overweight and obesity; Neonatal health; Randomised trial; Dietary and lifestyle intervention
Rights: © 2014 Dodd et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 0030013914
DOI: 10.1186/s12916-014-0163-9
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Appears in Collections:Paediatrics publications

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