Life-Moms: Effects Of A Lifestyle Intervention In Overweight And Obese Pregnant Women On Physical Activity

Two out of every three pregnant persons have overweight and obesity and almost half will experience excess gestational weight gain (GWG), which is associated with adverse maternal and neonatal outcomes. In the Lifestyle Interventions in Expectant Moms (LIFE-Moms) consortium, interventions in pregnancy with diet, physical activity (PA), and behavior change components significantly reduced GWG compared to usual care. PURPOSE: The aim of this analysis was to examine the effect of the intervention on PA and excess GWG. METHODS: 522 racially and socioeconomically diverse pregnant women with overweight (n = 241) and obesity (n = 281) (30.4 ± 5.7 y; 20.5% Hispanic; 37.0% African American; 34.7% White; 7.9% other) were enrolled at 13.8 ± 1.6 weeks gestation and randomized to standard care or an intervention group. Measures of inactive time and average daily PA levels (time spent in light, moderate, and vigorous activity, time spent in moderate to vigorous PA (MVPA), and MVPA time bouts ≥1 min and 10 min) were assessed using the ActiGraph GT3X+ at enrollment and 35 to 36 weeks gestation (3rd trimester). GWG is the difference between pregravid weight and weight at 3rd trimester. GWG was compared to the IOM weight gain guidelines to determine excessive GWG. Generalized linear models were used to test the time effect between baseline and 3rd trimester adjusting for intervention assignment, random effect for site, and covariates of race, parity, and BMI from baseline. RESULTS: For the total sample, inactive time and average daily activity levels significantly decreased from baseline to end of pregnancy (p < 0.002 for all) except time spent in light activity (162.1 ± 45.7 min vs. 164.6 ± 45.9 min), which was maintained. Total MVPA at ~13 weeks was a significant predictor of excess 3rd trimester GWG (β: 1.239; 95% confidence interval: 1.001, 1.534; p = 0.049). Between the standard care and intervention group, baseline MVPA time bouts ≥1 min was a significant predictor of excess 3rd trimester GWG (β: 1.327; 95% confidence interval: 1.082,1.628; p = 0.007). CONCLUSION: Baseline PA levels in pregnant women living with overweight and obesity are important determinants of end of pregnancy excess GWG. Future strategies aimed at maintaining MVPA time throughout pregnancy may prevent excess GWG in pregnant women with overweight and obesity. 1U01DK09441801