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Feasibility of conducting an early pregnancy diet and lifestyle e-health intervention: the Pregnancy Lifestyle Activity Nutrition (PLAN) project

Published online by Cambridge University Press:  08 August 2019

Rae-Chi Huang
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Desiree Silva
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
Lawrie Beilin
Affiliation:
Medical School, The University of Western Australia, Crawley, Western Australia, Australia
Cliff Neppe
Affiliation:
Joondalup Health Campus, Shenton Ave, Joondalup, Western Australia, Australia
Katherine E. Mackie
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Emma Roffey
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Lisa Y. Gibson
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Nina D’Vaz
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Hayley Christian
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
Christopher M. Reid
Affiliation:
School of Public Health, Curtin University, Perth, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Susan L. Prescott
Affiliation:
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
Corresponding

Abstract

Background:

Childhood obesity is a global issue. Excessive weight gain in early pregnancy is independently associated with obesity in the next generation. Given the uptake of e-health, our primary aim was to pilot the feasibility of an e-health intervention, starting in the first trimester, to promote healthy lifestyle and prevent excess weight gain in early pregnancy. Methods: Women were recruited between 8 and 11 weeks gestation and randomised to the intervention or routine antenatal care. The intervention involved an e-health program providing diet, physical activity and well-being advice over 12 weeks.

Results:

Women (n = 57, 43.9% overweight/obese) were recruited at 9.38 ± 1.12 (control) and 9.06 ± 1.29 (intervention) weeks’ gestation, mainly from obstetric private practices (81.2%). Retention was 73.7% for the 12-week intervention, 64.9% at birth and 55.8% at 3 months after birth.

No difference in gestational weight gain or birth size was detected. Overall treatment effect showed a mean increase in score ranking the perceived confidence of dietary change (1.2 ± 0.46, p = 0.009) and score ranking readiness to exercise (1.21 ± 0.51, p = 0.016) over the intervention. At 3 months, infants weighed less in the intervention group (5405 versus 6193 g, p = 0.008) and had a lower ponderal index (25.5 ± 3.0 versus 28.8 ± 4.0 kg/m3) compared with the control group.

Conclusion and Discussion:

A lifestyle intervention starting in the first-trimester pregnancy utilising e-health mode of delivery is feasible. Future studies need strategies to target recruitment of participants of lower socio-economic status and ensure maximal blinding. Larger trials (using technology and focused on early pregnancy) are needed to confirm if decreased infant adiposity is maintained.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

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