TY - JOUR

T1 - A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity

T2 - the DALI randomised controlled trial

AU - van Poppel, Mireille N.M.

AU - Simmons, David

AU - Devlieger, Roland

AU - van Assche, F. Andre

AU - Jans, Goele

AU - Galjaard, Sander

AU - Corcoy, Rosa

AU - Adelantado, Juan M.

AU - Dunne, Fidelma

AU - Harreiter, Jürgen

AU - Kautzky-Willer, Alexandra

AU - Damm, Peter

AU - Mathiesen, Elisabeth R.

AU - Jensen, Dorte M.

AU - Andersen, Lise Lotte

AU - Tanvig, Mette

AU - Lapolla, Annunziata

AU - Dalfra, Maria G.

AU - Bertolotto, Alessandra

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David

AU - Snoek, Frank J.

AU - Jelsma, Judith G.M.

AU - Desoye, Gernot

PY - 2019

Y1 - 2019

N2 - 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 ≥29 kg/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 (−1.8 mm; 95% CI −3.5, −0.2; p = 0.03), fat mass (−63 g; 95% CI −124, −2; p = 0.04), fat percentage (−1.2%; 95% CI −2.4%, −0.04%; p = 0.04) and leptin (−3.80 μg/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 μg/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. Trial registration: ISRCTN70595832.

AB - 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 ≥29 kg/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 (−1.8 mm; 95% CI −3.5, −0.2; p = 0.03), fat mass (−63 g; 95% CI −124, −2; p = 0.04), fat percentage (−1.2%; 95% CI −2.4%, −0.04%; p = 0.04) and leptin (−3.80 μg/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 μg/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. Trial registration: ISRCTN70595832.

KW - Lifestyle intervention

KW - Mediation

KW - Neonatal adiposity

KW - Randomised controlled trial

U2 - 10.1007/s00125-019-4842-0

DO - 10.1007/s00125-019-4842-0

M3 - Journal article

C2 - 30840112

AN - SCOPUS:85062781450

VL - 62

SP - 915

EP - 925

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 6

ER -