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

J Dev Orig Health Dis. 2020 Feb;11(1):58-70. doi: 10.1017/S2040174419000400. Epub 2019 Aug 8.

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.

Keywords: First trimester; feasibility; intervention; pregnancy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diet, Healthy
  • Feasibility Studies
  • Female
  • Gestational Weight Gain / physiology*
  • Health Promotion
  • Humans
  • Infant
  • Internet-Based Intervention
  • Maternal Nutritional Physiological Phenomena / physiology
  • Overweight / physiopathology
  • Overweight / prevention & control*
  • Pediatric Obesity / physiopathology
  • Pediatric Obesity / prevention & control*
  • Pregnancy
  • Pregnancy Trimester, First / physiology
  • Prenatal Care / methods*
  • Prenatal Exposure Delayed Effects / physiopathology
  • Prenatal Exposure Delayed Effects / prevention & control*
  • Risk Reduction Behavior