The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian Fit for Delivery randomised controlled trial

Abstract

Objective: To examine the effect of a prenatal lifestyle intervention on postpartum weight retention (PPWR).

Design: Randomised controlled trial.

Setting: Healthcare clinics in southern Norway.

Population: Healthy, nulliparous women with body mass index ≥19 kg/m² , age ≥18 years, and singleton pregnancy of ≤20 gestational weeks.

Methods: Women were randomised to intervention (dietary counselling twice by phone and access to twice-weekly exercise groups during pregnancy) or control group (standard prenatal care). Intervention compliance was defined post-factum as attending dietary counselling and ≥14 exercise classes.

Main outcome measures: PPWR (weight measured postpartum minus self-reported pre-pregnancy weight) and the proportion of women returning to pre-pregnancy weight.

Results: Of 606 women randomised, 591 were included in an intention-to-treat analysis of pregnancy outcomes and 391 (64.5%) were analysed 12 months postpartum. Mean PPWR was not significantly different between groups (0.66 kg for intervention versus 1.42 kg for control group, mean difference -0.77 kg, 95% CI -1.81, 0.28; P = 0.149). An increased proportion of intervention participants achieved pre-pregnancy weight (53% versus 43%, OR 1.50, 95% CI 1.003, 1.471; P = 0.045). However, the difference was not statistically significant when we adjusted for missing data (adjusted odds ratio (OR) 2.23, P = 0.067) using logistic mixed-effects models analysis. Women compliant with intervention had significantly lower PPWR than control participants, also after adjusting for potential confounders (adjusted mean diff -1.54 kg, 95% CI -3.02, -0.05; P = 0.039).

Conclusions: The Norwegian Fit for Delivery intervention had little effect on PPWR, although women who were compliant with the intervention demonstrated significantly lower PPWR at 12 months.

Tweetable abstract: Norwegian Fit for Delivery RCT: little effect of lifestyle intervention on weight retention 1 year postpartum.

Keywords: Lifestyle; postpartum; pregnancy; weight gain; weight retention.