Antenatal Lifestyle Interventions Improve Pregnancy Outcomes

Allison Shelley

June 21, 2016

 

During pregnancy, early interventions to improve diet and exercise lower the risk for gestational diabetes and ameliorate outcomes for women and their babies, meeting attendees heard during a well-attended session at the American Diabetes Association 76th Scientific Sessions in New Orleans.

But one size does not fit all when it comes to pregnancy weight gain, said session chair Patrick Catalano, MD, director of the Center for Reproductive Health at MetroHealth and Case Western Reserve University in Cleveland.

"There is a lot of variation," he told Medscape Medical News after the session. "There are individual physiologic and metabolic factors and societal, ethnic, and cultural differences that can all influence weight during pregnancy."

A one-time prescription for healthy eating and exercise probably won't help most women. "It needs to be an ongoing conversation that evolves over the course of the pregnancy," he explained. And interventions need to be adjusted along the way.

Calorie counts and energy expenditure are part of the issue, "but metabolic changes also take place during pregnancy that we don't know all that much about yet, and that may complicate interventions," Dr Catalano pointed out.

Recommendations on weight gain during pregnancy, issued by the Institute of Medicine, are an excellent starting point, Dr Catalano said.

 
There are individual physiologic and metabolic factors and societal, ethnic, and cultural differences that can all influence weight during pregnancy.
 

But, he added, physicians are not always the best professionals to help these women. Nutritionists, behaviorists, and exercise therapists are often in a better position to provide appropriate advice and counseling.

"My practice has a nutritionist and I wish we had a behaviorist," said Dr Catalano. "There are economic implications and, of course, even healthy eating can be expensive and therefore inaccessible to many."

Several health systems do not pay for the nutritional or exercise counseling that would benefit mothers and babies, said presenter William Knowler, MD, from the National Institute of Diabetes and Digestive and Kidney Diseases.

"There were a lot of questions after the session," Dr Knowler told Medscape Medical News. "The informal sentiment I heard afterward is that it's unfortunate that our current interventions aren't more beneficial and there hasn't been more progress in this important area."

Dr Catalano and Dr Knowler have disclosed no relevant financial relationships.

American Diabetes Association (ADA) 76th Scientific Sessions: Session 3-CT-SY04. Presented June 11, 2016.

Follow Allison Shelley on Twitter: @allishelley

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