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Randomized Controlled Trial
. 2011 Jul;34(7):1519-25.
doi: 10.2337/dc10-2221. Epub 2011 May 3.

A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial

Assiamira Ferrara  1 , Monique M Hedderson, Cheryl L Albright, Samantha F Ehrlich, Charles P Quesenberry Jr, Tiffany Peng, Juanran Feng, Jenny Ching, Yvonne Crites
Affiliations
Randomized Controlled Trial

A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial

Assiamira Ferrara et al. Diabetes Care. 2011 Jul.

Abstract

Objective: To pilot, among women with gestational diabetes mellitus (GDM), the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program. The intervention was delivered by telephone, and support for breastfeeding was addressed.

Research design and methods: The goal was to help women return to their prepregnancy weight, if it was normal, or achieve a 5% reduction from prepregnancy weight if overweight. Eligible participants were identified shortly after a GDM diagnosis; 83.8% consented to be randomly assigned to intervention or usual medical care (96 and 101 women, respectively). The retention was 85.2% at 12 months postpartum.

Results: The proportion of women who reached the postpartum weight goal was higher, although not statistically significant, in the intervention condition than among usual care (37.5 vs. 21.4%, absolute difference 16.1%, P=0.07). The intervention was more effective among women who did not exceed the recommended gestational weight gain (difference in the proportion of women meeting the weight goals: 22.5%, P=0.04). The intervention condition decreased dietary fat intake more than the usual care (condition difference in the mean change in percent of calories from fat: -3.6%, P=0.002) and increased breastfeeding, although not significantly (condition difference in proportion: 15.0%, P=0.09). No differences in postpartum physical activity were observed between conditions.

Conclusions: This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight. Strategies to help postpartum women overcome barriers to increasing physical activity are needed.

Trial registration: ClinicalTrials.gov NCT00460018.

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Figures

Figure 1
Figure 1
Flow chart of participant recruitment and retention, Kaiser Permanente Northern California, 2005–2009.
See this image and copyright information in PMC

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