Simpson, Sharon A, Coulman, Elinor, Gallagher, Dunla, Jewell, Karen, Cohen, David, Newcombe, Robert G, Huang, Chao, Robles, Jose Antonio, Busse, Monica, Owen-Jones, Eleri et al (show 6 more authors)
(2021)
Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum.
INTERNATIONAL JOURNAL OF OBESITY, 45 (8).
pp. 1728-1739.
Abstract
<h4>Objective</h4>To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth.<h4>Methods</h4>Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m<sup>2</sup> (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined.<h4>Interventions</h4>Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy.<h4>Results</h4>Mean (SD) BMI at 12 months postpartum was 36.0 kg/m<sup>2</sup> (5.2) in the control group, and 37.5 kg/m<sup>2</sup> (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was -0.02 (95% CI -0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds.<h4>Conclusions</h4>There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking.<h4>Trial registration</h4>Current Controlled Trials ISRCTN25260464.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Pregnancy Complications, Obesity, Postpartum Period, Pregnancy, Adult, Female, Young Adult, Weight Reduction Programs, Healthy Lifestyle, Diet, Healthy |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 30 Jul 2021 11:55 |
| Last Modified: | 18 Jan 2023 21:34 |
| DOI: | 10.1038/s41366-021-00835-0 |
| Open Access URL: | https://www.nature.com/articles/s41366-021-00835-0... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3131830 |
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