Original Article

International Journal of Obesity advance online publication 21 March 2017; doi: 10.1038/ijo.2017.44

Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy

N Patel1, K M Godfrey2, D Pasupathy1, J Levin3, A C Flynn1,4, L Hayes5, A L Briley1, R Bell5, D A Lawlor6, E Oteng-Ntim7, S M Nelson8, S C Robson9, N Sattar10, C Singh7, J Wardle11,maltese cross, S L White1, P T Seed1 and L Poston1 on behalf of the UPBEAT Consortium

  1. 1Division of Women’s Health, Women’s Health Academic Centre, Faculty of Life Sciences and Medicine, King’s College London, St Thomas’ Hospital, London, UK
  2. 2MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
  3. 3Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  4. 4Division of Diabetes and Nutritional Sciences, King’s College London, London, UK
  5. 5Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  6. 6MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, Bristol, UK
  7. 7Department of Obstetrics and Gynaecology, Guys and St Thomas’ NHS Foundation Trust, London, UK
  8. 8School of Medicine, University of Glasgow, Glasgow, UK
  9. 9Institute of Cellular Medicine Uterine Cell Signalling Group Newcastle University, Newcastle, UK
  10. 10Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
  11. 11Health Behaviour Research Centre, Institute of Epidemiology and Health, University College London, London, UK

Correspondence: Dr N Patel, Division of Women’s Health, Women’s Health Academic Centre, Faculty of Life Sciences and Medicine, King’s College London, St Thomas’ Hospital, 10th Floor North Wing, London SE1 7EH, UK. E-mail: Nashita.r.patel@kcl.ac.uk

maltese crossDeceased.

Received 16 August 2016; Revised 9 November 2016; Accepted 31 January 2017
Accepted article preview online 20 February 2017; Advance online publication 21 March 2017

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Abstract

Objectives:

 

Randomised controlled trials are required to address causality in the reported associations between maternal influences and offspring adiposity. The aim of this study was to determine whether an antenatal lifestyle intervention, associated with improvements in maternal diet and reduced gestational weight gain (GWG) in obese pregnant women leads to a reduction in infant adiposity and sustained improvements in maternal lifestyle behaviours at 6 months postpartum.

Subjects and methods:

 

We conducted a planned postnatal follow-up of a randomised controlled trial (UK Pregnancies Better Eating and Activity Trial (UPBEAT)) of a complex behavioural intervention targeting maternal diet (glycaemic load (GL) and saturated fat intake) and physical activity in 1555 obese pregnant women. The main outcome measure was infant adiposity, assessed by subscapular and triceps skinfold thicknesses. Maternal diet and physical activity, indices of the familial lifestyle environment, were assessed by questionnaire.

Results:

 

A total of 698 (45.9%) infants (342 intervention and 356 standard antenatal care) were followed up at a mean age of 5.92 months. There was no difference in triceps skinfold thickness z-scores between the intervention vs standard care arms (difference −0.14s.d., 95% confidence interval −0.38 to 0.10, P=0.246), but subscapular skinfold thickness z-score was 0.26 s.d. (−0.49 to −0.02; P=0.03) lower in the intervention arm. Maternal dietary GL (−35.34; −48.0 to −22.67; P<0.001) and saturated fat intake (−1.93% energy; −2.64 to −1.22; P<0.001) were reduced in the intervention arm at 6 months postpartum. Causal mediation analysis suggested that lower infant subscapular skinfold thickness was partially mediated by changes in antenatal maternal diet and GWG rather than postnatal diet.

Conclusions:

 

This study provides evidence from follow-up of a randomised controlled trial that a maternal behavioural intervention in obese pregnant women has the potential to reduce infant adiposity and to produce a sustained improvement in maternal diet at 6 months postpartum.

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