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A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial

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  • Mireille N M van Poppel
  • David Simmons
  • Roland Devlieger
  • F Andre van Assche
  • Goele Jans
  • Sander Galjaard
  • Rosa Corcoy
  • Juan M Adelantado
  • Fidelma Dunne
  • Jürgen Harreiter
  • Alexandra Kautzky-Willer
  • Peter Damm
  • Elisabeth R Mathiesen
  • Dorte M Jensen
  • Lise-Lotte Andersen
  • Mette Tanvig
  • Annunziata Lapolla
  • Maria G Dalfra
  • Alessandra Bertolotto
  • Ewa Wender-Ozegowska
  • Agnieszka Zawiejska
  • David Hill
  • Frank J Snoek
  • Judith G M Jelsma
  • Gernot Desoye
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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/m2 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.

Original languageEnglish
JournalDiabetologia
Volume62
Issue number6
Pages (from-to)915-925
Number of pages11
ISSN0012-186X
DOIs
Publication statusPublished - Jun 2019

ID: 57341384