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. 2023 Jul;27(7):1133-1139.
doi: 10.1007/s10995-023-03624-5. Epub 2023 Mar 21.

Reducing Maternal Obesity and Diabetes Risks Prior to Conception with the National Diabetes Prevention Program

Natalie D Ritchie  1   2   3 , Katherine A Sauder  4   5 , Marisa Kostiuk  6
Affiliations

Reducing Maternal Obesity and Diabetes Risks Prior to Conception with the National Diabetes Prevention Program

Natalie D Ritchie et al. Matern Child Health J. 2023 Jul.

Abstract
in English, Spanish

Introduction: Intrauterine exposure to maternal obesity and hyperglycemia greatly increases offspring health risks. Scalable lifestyle interventions to lower weight and glycemia prior to conception are needed, but have been understudied, especially in diverse and low-income women with disproportionately high risks of negative maternal-child outcomes. The objective of this report is to provide initial evidence of the National Diabetes Prevention Program's (NDPP) effects on maternal-child outcomes in diverse, low-income women and their offspring.

Methods: The yearlong NDPP was delivered in a safety net healthcare system to 1,569 participants from 2013 to 2019. Using medical records, we evaluated outcomes for women < 40 years who became pregnant and delivered after attending the NDPP for ≥ 1 month (n = 32), as compared to a usual care group of women < 40 years (n = 26) who were initially eligible for the NDPP but were excluded due to pregnancy at enrollment.

Results: Most women in either group were Latinx, had Medicaid or were uninsured, and had obesity at baseline. The mean difference in BMI change from baseline to conception was - 1.8 ± 0.6 kg/m2 (p = 0.002) for NDPP versus usual care. Fewer NDPP participants had obesity at conception (56.7% vs. 88.0%, p = 0.011) and hyperglycemia in early pregnancy (4.0% vs. 25.0%; p = 0.020) than usual care. No other differences were statistically significant, yet nearly all outcomes favored the NDPP. Covariate-adjusted results were consistent, except the difference in frequency of obesity at conception was no longer significant (p = 0.132).

Discussion: Results provide preliminary evidence that the NDPP may support a reduction in peri-conceptional obesity/diabetes risks among diverse and low-income women.

Scalable lifestyle interventions to lower weight and glycemia prior to conception are needed, especially to support diverse and low-income women with disproportionately high risks of negative maternal-child outcomes. This report presents initial evidence of the National Diabetes Prevention Program?s effects on maternal-child outcomes in diverse, low-income women and their offspring. Results encouragingly suggest that the program can reduce peri-conceptional obesity and glycemia, and may be a resource to help break the cycle of disease across generations.

Keywords: Glycosylated Hemoglobin; Lifestyle Intervention; Obesity; Pregnancy; Prevention; Weight Loss.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram for the National Diabetes Prevention Program (NDPP) and usual care groups
See this image and copyright information in PMC

References

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