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

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dc.contributor.authorInternational Weight Management in Pregnancy (i-WIP) Collaborative Group,
dc.date.issued2017
dc.descriptionAuthor for the University of Adelaide: K S Khan. Corrected by: Erratum: BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3991 (Published 23 August 2017). In this Research paper by Rogozinksa and colleagues (BMJ 2017;358:j3119, doi: 10.1136/bmj.j3119) Ruben Barakat (professor) should have been listed as an author in the details of the International Weight Management in Pregnancy (i-WIP) Collaborative Group in the endmatter.
dc.description.abstractOBJECTIVE To synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women’s body mass index, age, parity, ethnicity, and pre-existing medical condition; and secondarily on individual complications. DESIGN Systematic review and meta-analysis of individual participant data (IPD). DATA SOURCES Major electronic databases from inception to February 2017 without language restrictions. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised trials on diet and physical activity based interventions in pregnancy. DATA SYNTHESIS Statistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall, and in subgroups (interactions). RESULTS IPD were obtained from 36 randomised trials (12 526 women). Less weight gain occurred in the intervention group than control group (mean difference −0.70 kg, 95% confidence interval −0.92 to −0.48 kg, I2=14.1%; 33 studies, 9320 women). Although summary effect estimates favoured the intervention, the reductions in maternal (odds ratio 0.90, 95% confidence interval 0.79 to 1.03, I2=26.7%; 24 studies, 8852 women) and offspring (0.94, 0.83 to 1.08, I2=0%; 18 studies, 7981 women) composite outcomes were not statistically significant. No evidence was found of differential intervention effects across subgroups, for either gestational weight gain or composite outcomes. There was strong evidence that interventions reduced the odds of caesarean section (0.91, 0.83 to 0.99, I2=0%; 32 studies, 11 410 women), but not for other individual complications in IPD meta-analysis. When IPD were supplemented with study level data from studies that did not provide IPD, the overall effect was similar, with stronger evidence of benefit for gestational diabetes (0.76, 0.65 to 0.89, I2=36.8%; 59 studies, 16 885 women). CONCLUSION Diet and physical activity based interventions during pregnancy reduce gestational weight gain and lower the odds of caesarean section. There is no evidence that effects differ across subgroups of women.
dc.description.statementofresponsibilityThe International Weight Management in Pregnancy (i-WIP) Collaborative Group
dc.identifier.citationBMJ Open, 2017; 358(3119):1-15
dc.identifier.doi10.1136/bmj.j3119
dc.identifier.issn2044-6055
dc.identifier.issn1756-1833
dc.identifier.urihttp://hdl.handle.net/2440/106506
dc.language.isoen
dc.publisherBMJ Journals
dc.rightsThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) 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 noncommercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.source.urihttps://doi.org/10.1136/bmj.j3119
dc.subjectInternational Weight Management in Pregnancy (i-WIP) Collaborative Group
dc.subjectHumans
dc.subjectPregnancy Complications
dc.subjectObesity
dc.subjectWeight Gain
dc.subjectPregnancy Outcome
dc.subjectExercise Therapy
dc.subjectDiet
dc.subjectPregnancy
dc.subjectFemale
dc.subjectRandomized Controlled Trials as Topic
dc.titleEffect 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
dc.typeJournal article
pubs.publication-statusPublished

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