A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial
Por:
van Poppel, MNM, Simmons, D, Devlieger, R, van Assche, FA, Jans, G, Galjaard, S, Corcoy, R, Adelantado, JM, Dunne, F, Harreiter, J, Kautzky-Willer, A, Damm, P, Mathiesen, ER, Jensen, DM, Andersen, LL, Tanvig, M, Lapolla, A, Dalfra, MG, Bertolotto, A, Wender-Ozegowska, E, Zawiejska, A, Hill, D, Snoek, FJ, Jelsma, JGM, Desoye, G
Publicada:
1 jun 2019
Resumen:
Aims/hypothesis Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity.
Methods In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI >= 29kg/m(2) were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed.
Results Outcomes were available from 334 neonates. A reduction in sum of skinfolds (-1.8mm; 95% CI -3.5, -0.2; p=0.03), fat mass (-63g; 95% CI -124, -2; p=0.04), fat percentage (-1.2%; 95% CI -2.4%, -0.04%; p=0.04) and leptin (-3.80 mu g/l; 95% CI -7.15, -0.45; p=0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (-5.79 mu g/l; 95% CI -11.43, -0.14; p=0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups.
Conclusions/interpretation The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated.
Filiaciones:
van Poppel, MNM:
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Publ & Occupat Hlth, Amsterdam UMC, Amsterdam, Netherlands
Karl Franzens Univ Graz, Inst Sport Sci, Mozartgasse 14, A-8010 Graz, Austria
Simmons, D:
Western Sydney Univ, Macarthur Clin Sch, Sydney, NSW, Australia
Addenbrookes Hosp, Inst Metab Sci, Cambridge, England
Devlieger, R:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Dept Gynaecol & Obstet, Leuven, Belgium
van Assche, FA:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Dept Gynaecol & Obstet, Leuven, Belgium
Jans, G:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Dept Gynaecol & Obstet, Leuven, Belgium
Galjaard, S:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Dept Gynaecol & Obstet, Leuven, Belgium
Erasmus Univ, Med Ctr, Dept Obstet & Gynaecol, Div Obstet & Prenatal Med, Rotterdam, Netherlands
Corcoy, R:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
ISCIII, Ctr Invest Biomed Red CIBER Bioengn Biomat & Nano, Madrid, Spain
Adelantado, JM:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Dunne, F:
Natl Univ Ireland, Galway Diabet Res Ctr, Galway, Ireland
Natl Univ Ireland, Coll Med Nursing & Hlth Sci, Galway, Ireland
Harreiter, J:
Med Univ Vienna, Dept Internal Med 3, Gender Med Unit, Endocrinol & Metab, Vienna, Austria
Kautzky-Willer, A:
Med Univ Vienna, Dept Internal Med 3, Gender Med Unit, Endocrinol & Metab, Vienna, Austria
Damm, P:
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Ctr Pregnant Women Diabet,Rigshosp,Dept Endocrino, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Ctr Pregnant Women Diabet,Rigshosp,Dept Obstet, Copenhagen, Denmark
Mathiesen, ER:
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Ctr Pregnant Women Diabet,Rigshosp,Dept Endocrino, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Ctr Pregnant Women Diabet,Rigshosp,Dept Obstet, Copenhagen, Denmark
Jensen, DM:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Andersen, LL:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Tanvig, M:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Reg Southern Denmark, Odense, Denmark
Lapolla, A:
Univ Padua, Dipartimento Med, Padua, Italy
Dalfra, MG:
Univ Padua, Dipartimento Med, Padua, Italy
Bertolotto, A:
Azienda Osped Univ Pisana, Dept Clin & Expt Med, Pisa, Italy
Wender-Ozegowska, E:
Poznan Univ Med Sci, Med Fac 1, Poznan, Poland
Zawiejska, A:
Poznan Univ Med Sci, Med Fac 1, Poznan, Poland
Hill, D:
Rech Sante Lawson SA, Bronschhofen, Switzerland
Snoek, FJ:
Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Med Psychol, Amsterdam, Netherlands
Jelsma, JGM:
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Publ & Occupat Hlth, Amsterdam UMC, Amsterdam, Netherlands
Desoye, G:
Med Univ Graz, Dept Obstet & Gynaecol, Graz, Austria
Green Published, Hybrid Gold
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