Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials.

CONTEXT: Interventions targeting maternal obesity are a healthcare and public health priority. OBJECTIVE: The objective of this review was to evaluate the adequacy and effectiveness of the methodological designs implemented in dietary intervention trials for obesity in pregnancy. DATA SOURCES: A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. STUDY SELECTION: Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women, were identified. DATA SYNTHESIS: There was significant variability in the content, delivery, and dietary assessment methods of the dietary interventions examined. A number of studies demonstrated improved dietary behavior in response to diet and/or lifestyle interventions. Nine studies reduced gestational weight gain. CONCLUSION: This review reveals large methodological variability in dietary interventions to control gestational weight gain and improve clinical outcomes in overweight and obese pregnant women. This lack of consensus limits the ability to develop clinical guidelines and apply the evidence in clinical practice.

Ejercicio físico y los resultados del embarazo / Physical exercise and pregnancy outcome

Introducción: Son bien conocidos los efectos beneficiosos que el ejercicio físico tiene sobre la salud en general, aunque no se cuenta con la misma información cuando se refiere a un proceso de notable importancia: el embarazo. La mayor incertidumbre es saber si pueden coexistir ambos procesos, ejercicio y embarazo, sin conflictos maternofetales y sin que se vean alterados los resultados del embarazo, especialmente cuando día a día son más las mujeres que desean continuar ejercitándose de alguna forma durante la gestación. Objetivo: Conocer la influencia del ejercicio físico aeróbico moderado desarrollado durante el segundo y tercer trimestres de embarazo en los resultados de éste. Material y método: Se llevó a cabo un ensayo de campo, que incluyó a un total de 142 gestantes. El grupo de tratamiento estuvo integrado por 72 mujeres y el grupo control por 70. Los parámetros maternos estudiados fueron: edad gestacional, ganancia de peso, sobrecarga oral de glucosa (test de O'Sullivan), tipo de parto, valor de hemoglobina previo al parto, presión arterial durante el curso del embarazo (media). Los parámetros fetales fueron: peso al nacimiento, talla, perímetro craneal, test de Apgar (1 y 5 min), pH del cordón umbilical. Resultados: No se encontraron diferencias estadísticamente significativas entre ambos grupos (p < 0,05); no obstante, el grupo de tratamiento (ejercicio) presentó medias inferiores respecto a la ganancia de peso materno (11,4 ± 3,7 kg) y el peso al nacimiento (3.165,3 ± 431,8 g) que el grupo control (12,3 ± 3,3 kg y 3.307,4 ± 474,2 g, respectivamente). Los datos se presentan con las medias más la desviación estándar. Conclusión: El ejercicio aeróbico moderado desarrollado durante el segundo y tercer trimestres de embarazo parece no alterar los resultados de éste

Introduction: The beneficial effects of physical exercise on health in general are well known. However, less is known about the effects of exercise on the highly important process of pregnancy. The greatest uncertainty concerns whether both processes --exercise and pregnancy-- can coexist, without maternal-fetal conflicts and without altering pregnancy outcome. Currently, an increasing number of women wish to continue some form of exercise during pregnancy. Objective: To determine the influence of moderate aerobic exercise in the second and third trimesters of pregnancy on pregnancy outcome. Material and method: We performed a randomized, controlled, open trial in 142 pregnant women. There were 72 women in the treatment group and 70 on the control group. The maternal variables studied were gestational age, weight gain, oral glucose load (O'Sullivan's test), type of delivery, hemoglobin level before delivery, and mean blood pressure during the course of pregnancy. The fetal variables studied were birth weight, length, head circumference, Apgar test at 1 and 5 min, and umbilical cord pH value. Results: No statistically significant differences were found between the two groups (p < 0.05). However, in the treatment group (exercise), mean (± SD) maternal weight gain (11.4 ± 3.7 kg) and birth weight (3165.3 ± 431.8 g) were lower than in the control group (12.3 ± 3.3 kg and 3307.4 ± 474.2 g). Conclusion: Moderate aerobic exercise during the second and third trimesters of pregnancy seems not to alter pregnancy outcomes