Metabolic Health and Heterogenous Outcomes of Prenatal Interventions: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
In this preplanned secondary analysis of a randomized clinical trial of an IBT on GWG among pregnant individuals, those with MUO experienced less GWG, had a higher incidence of gestational diabetes, and had infants with a higher proportion of adiposity compared with those who MHO. Data supported that the maternal obesity metabolic phenotype has a greater clinical effect on adverse maternal and infant clinical outcomes compared with GWG alone and did not contribute to a differential response to a lifestyle intervention. Future interventions should identify methods to better optimize the maternal metabolic milieu as early in pregnancy as possible to reduce the intergenerational transmission of metabolic disease.
Study context
- Population
- Pregnant women with obesity, viable singleton pregnancy, no previous cardiometabolic disease; mean age 30.2 years, mean BMI 35.2
- Participants
- 640 women
- Comparison
- MUO vs MHO phenotype
- MUOn = 172
- MHOn = 228reference
- Primary endpoint
- GWG (total and adherence to guidelines), adverse perinatal outcomes, substrate changes and infant body composition
Methodological detailspreplanned secondary analysis, consortium of 7 multicenter RCTs, intention-to-treat
- Preplanned secondary analysis
- Consortium of 7 multicenter RCTs
- Intention-to-treat
Primary result
As reported in the abstract
- MUO and MHO did not differ in response to treatment in weight outcomes, adverse perinatal outcomes or substrate changes, except smaller TG increases with intervention more in MUO than MHO
- Intention-to-treat
Further findings
GWG (adjusted) · lower with MUO
difference 36.7% · P < 0.001
Exceeded weight gain guidelines
P = 0.03
GDM
P = 0.001
Infant adiposity (% fat)
P = 0.05
Mean
| Outcome | MUO | MHO | P value |
|---|---|---|---|
| TG increase in intervention group, by phenotype | 90.3% (SE 7.4%) | 81.8% (SE 8.3%) | P = 0.02 |
- Gestational weight gain (GWG) (adjusted): adjusted for maternal baseline demographics and treatment group
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →