TY - JOUR
T1 - Participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain
T2 - a systematic review and meta-analysis
AU - Grieger, Jessica A.
AU - Takele, Wubet Worku
AU - Vesco, Kimberly K.
AU - Redman, Leanne M.
AU - Hannah, Wesley
AU - Bonham, Maxine P.
AU - Chen, Mingling
AU - Chivers, Sian C.
AU - Fawcett, Andrea J.
AU - Habibi, Nahal
AU - Liu, Kai
AU - Mekonnen, Eskedar Getie
AU - Pathirana, Maleesa
AU - Quinteros, Alejandra
AU - Taylor, Rachael
AU - Ukke, Gebresilasea G.
AU - Zhou, Shao J.
AU - Franks, Paul W.
AU - Rich, Stephen S.
AU - Wagner, Robert
AU - Vilsbøll, Tina
AU - Udler, Miriam S.
AU - Tuomi, Tiinamaija
AU - Sweeting, Arianne
AU - Sims, Emily K.
AU - Sherr, Jennifer L.
AU - Semple, Robert K.
AU - Reynolds, Rebecca M.
AU - Redondo, Maria J.
AU - Pratley, Richard E.
AU - Pop-Busui, Rodica
AU - Pollin, Toni I.
AU - Perng, Wei
AU - Pearson, Ewan R.
AU - Ozanne, Susan E.
AU - Owen, Katharine R.
AU - Oram, Richard
AU - Murphy, Rinki
AU - Mohan, Viswanathan
AU - Misra, Shivani
AU - Meigs, James B.
AU - Mathioudakis, Nestoras
AU - Mathieu, Chantal
AU - Ma, Ronald C.W.
AU - Nolan, John J.
AU - Ried-Larsen, Mathias
AU - Hansen, Torben
AU - Clemmensen, Christoffer
AU - Andersen, Mette K.
AU - Thuesen, Anne Cathrine B.
AU - ADA/EASD PMDI
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/10/24
Y1 - 2025/10/24
N2 - Background: Precision prevention involves tailoring interventions to the unique characteristics of a group or individual to maximize their effectiveness. In this study, we examined the role of participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain (GWG). Methods: We searched Medline, Embase, and PubMed, from inception up to March 2025, to identify randomized and non-randomized controlled trials of lifestyle interventions (diet, physical activity, or combined) commencing before or during pregnancy. Participant characteristics, including age, race/ethnicity, body mass index (BMI), employment status, fasting low- and high-density lipoprotein cholesterol (HDL-C) were assessed. Mean differences (MD) in GWG were pooled using the random-effect model. Meta-regression and subgroup analysis were conducted by participant characteristics (e.g., BMI). Results: A total of 86 studies with 28,270 participants were included in this systematic review and meta-analysis. All lifestyle intervention types significantly reduced GWG. Combined lifestyle interventions initiated at first (MD −0.68; 95% confidence interval [CI]: −1.28, −0.07) and early second (13–17 weeks) trimester (MD −0.83; 95% CI: −1.46, −0.20) provide better effectiveness in optimizing GWG. Diet-only interventions significantly reduced GWG only in participants with normal BMI (MD −1.33 kg; CI: −1.75, −1.91) compared to the other BMI categories. Combined diet and physical activity interventions reduce excessive GWG in women with higher baseline HDL-C (β −0.04; 95% CI −0.06, −0.01). Conclusions: Lifestyle interventions reduced excessive GWG, with possible differential effects by intervention initiation time, BMI, and HDL-C. Future studies should consider physiological as well as social characteristics, in line with a holistic framework for precision medicine.
AB - Background: Precision prevention involves tailoring interventions to the unique characteristics of a group or individual to maximize their effectiveness. In this study, we examined the role of participant characteristics in the effectiveness of lifestyle interventions to optimize gestational weight gain (GWG). Methods: We searched Medline, Embase, and PubMed, from inception up to March 2025, to identify randomized and non-randomized controlled trials of lifestyle interventions (diet, physical activity, or combined) commencing before or during pregnancy. Participant characteristics, including age, race/ethnicity, body mass index (BMI), employment status, fasting low- and high-density lipoprotein cholesterol (HDL-C) were assessed. Mean differences (MD) in GWG were pooled using the random-effect model. Meta-regression and subgroup analysis were conducted by participant characteristics (e.g., BMI). Results: A total of 86 studies with 28,270 participants were included in this systematic review and meta-analysis. All lifestyle intervention types significantly reduced GWG. Combined lifestyle interventions initiated at first (MD −0.68; 95% confidence interval [CI]: −1.28, −0.07) and early second (13–17 weeks) trimester (MD −0.83; 95% CI: −1.46, −0.20) provide better effectiveness in optimizing GWG. Diet-only interventions significantly reduced GWG only in participants with normal BMI (MD −1.33 kg; CI: −1.75, −1.91) compared to the other BMI categories. Combined diet and physical activity interventions reduce excessive GWG in women with higher baseline HDL-C (β −0.04; 95% CI −0.06, −0.01). Conclusions: Lifestyle interventions reduced excessive GWG, with possible differential effects by intervention initiation time, BMI, and HDL-C. Future studies should consider physiological as well as social characteristics, in line with a holistic framework for precision medicine.
UR - https://www.scopus.com/pages/publications/105021016259
U2 - 10.1038/s43856-025-01049-5
DO - 10.1038/s43856-025-01049-5
M3 - Review
C2 - 41136661
AN - SCOPUS:105021016259
SN - 2730-664X
VL - 5
JO - Communications medicine
JF - Communications medicine
IS - 1
M1 - 439
ER -