• Maternal behaviors during pregnancy impact offspring obesity risk

      Phelan, S; Hart, C; Phipps, M; Abrams, B; Schaffner, A; Adams, A; Wing, R (2011-12-01)
      This study investigated the effects of maternal changes during pregnancy in diet, exercise, and psychosocial factors on offspring weight parameters at birth and 6 months. In overweight/obese (OW/OB; n = 132) mothers, greater % kcal from sweets early in pregnancy was the strongest, independent predictor of higher weight for age (WFA) (beta = 0. 19; P = 0. 004), higher odds of macrosomia (OR = 1.1 (1.01.2); P = 0. 004) andWFA 90th percentile at birth (OR = 1.2 (1.11.3); P = 0. 002) and higher WFA at 6 months (beta = 0. 30; P = 0. 002). In normal weight (n = 153) mothers, higher intake of soft drinks was the strongest predictor of higher offspring WFA at birth (beta = 0.16; P = 0. 04) but not at 6 months. Prenatal physical activity, depressive symptoms, and sleep-related variables did not significantly predict offspring weight outcomes. Mothers eating behaviors during pregnancy, especially intake of sweets in OW/OB mothers, may have a lasting effect on child weight. Copyright © 2011 Suzanne Phelan et al.
    • One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials

      Phelan, Suzanne; Clifton, Rebecca G; Haire-Joshu, Debra; Redman, Leanne M; Van Horn, Linda; Evans, Mary; Joshipura, Kaumudi; Couch, Kimberly A; Arteaga, S Sonia; Cahill, Alison G; Drews, Kimberly L; Franks, Paul W; Gallagher, Dympna; Josefson, Jami L; Klein, Samuel; Knowler, William C; Martin, Corby K; Peaceman, Alan M; Thom, Elizabeth A; Wing, Rena R; Yanovski, Susan Z; Pi-Sunyer, Xavier; Phelan, S; Wing, RR; Hagobian, TA; Schaffner, A; Hart, C; Yin, EK; Phipps, MG; Abrams, B; Scholl, TO; Savitz, DA; Gallagher, D; Pi-Sunyer, X; Thornton, J; Rosenn, B; Paley, C; Gidwani, S; Horowitz, M; Joshipura, K; Franks, PW; Palacios, C; Campos, M; Rivera, J; Willett, WC; Zorrilla, C; Soltero, S; Hu, F; Cordero, J; Trak, MA; Melendez, M; Cahill, AG; Klein, S; Haire-Joshu, D; Stein, R; Mathur, A; Cade, WT; Moley, K; Peaceman, AM; Van Horn, L; Kwasny, M; Josefson, JL; Neff, L; Spring, B; Redman, LM; Martin, CK; Elkind-Hirsh, K; Breaux, J; Johnson, W; Frost, EA; Knowler, WC; Couch, KA; Curtis, JM; Dunnigan, DL; Hanson, RL; Hoskin, M; Kavena, K; Kishi, GY; Moffett, C; Murphy, S; Nelson, RG; Pomeroy, J; Shovestull, L; Williams, Rachel; Clifton, RG; Thom, EA; Drews, K; Boekhoudt, T; Evans, M; Yanovski, SZ; Arteaga, S; Alekel, DL; Grp, LIFE-Moms Res (2020-01)
      BACKGROUND/OBJECTIVES: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. SUBJECTS/METHODS: In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. RESULTS: Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of -1.6 kg (95% CI -2.5, -0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. CONCLUSIONS: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.