0000000000143079
AUTHOR
Linda Reme Sagedal
Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial
Objective To examine whether a lifestyle intervention in pregnancy limits gestational weight gain (GWG) and provides measurable health benefits for mother and newborn. Design Randomised controlled trial. Setting Healthcare clinics of southern Norway. Population Healthy, non-diabetic, nulliparous women, aged ≥18 years, with a body mass index of ≥19 kg/m2 , and with a singleton pregnancy at ≤20 weeks of gestation. Methods Women were randomised to an intervention group (with dietary counselling twice by telephone and access to twice-weekly exercise groups) or to a control group (with standard prenatal care). Participants were measured three times during pregnancy and at delivery, and newborns …
The Fit for Delivery study: rationale for the recommendations and test-retest reliability of a dietary score measuring adherence to 10 specific recommendations for prevention of excessive weight gain during pregnancy
Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women. A 43-item FFQ was developed for the FFD study. A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations. Adding the subscales yielded a score from 0 to 10 with increasing sco…
Effect of a prenatal lifestyle intervention on physical activity level in late pregnancy and the first year postpartum
Background: Despite documented health benefits for mother and baby, physical activity (PA)-level tends to decline in pregnancy. Overweight/obese and physically inactive women are two selected groups at increased risk of pregnancy complications. Thus, efficient strategies to maintain or increase PA-level in pregnancy and the postpartum period, especially among these women, are warranted. This secondary analysis examined the effect of a prenatal lifestyle-intervention on PA-level in late pregnancy and the first year postpartum, with subanalysis on initially physically active versus inactive and normal-weight versus overweight/obese women. Method: The Norwegian Fit for Delivery (NFFD) randomiz…
How does a lifestyle intervention during pregnancy influence perceived barriers to leisure-time physical activity? The Norwegian fit for delivery study, a randomized controlled trial
Abstract Background To develop effective health promotional and preventive prenatal programs, it is important to understand perceived barriers to leisure-time physical activity during pregnancy, including exercise and sport participation. The aims of the present study was 1) to assess the effect of prenatal lifestyle intervention on the perceived barrier to leisure-time physical activity during pregnancy and the first year after delivery and 2) identify the most important perceived barriers to leisure-time physical activity at multiple time points during and after pregnancy. Methods This secondary analysis was part of the Norwegian Fit for Delivery study, a combined lifestyle intervention e…
Effect of a diet intervention during pregnancy on dietary behavior in the randomized controlled Norwegian Fit for Delivery study.
A mother’s diet during pregnancy has the potential to influence both her own and her child’s short- and long-term health. This paper reports the effects of a randomized controlled diet intervention during pregnancy on dietary behavior post-intervention as reported in late pregnancy. The diet intervention was part of a lifestyle intervention targeting both diet and physical activity behaviors among nulliparous women participating in the randomized controlled Norwegian Fit for Delivery study (NFFD). Eligible women were enrolled in early pregnancy from eight healthcare clinics in southern Norway between 2009 and 2013. The diet intervention was based on 10 dietary recommendations that were conv…
The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian Fit for Delivery randomised controlled trial.
Objective To examine the effect of a prenatal lifestyle intervention on postpartum weight retention (PPWR). Design Randomised controlled trial. Setting Healthcare clinics in southern Norway. Population Healthy, nulliparous women with body mass index ≥19 kg/m2 , age ≥18 years, and singleton pregnancy of ≤20 gestational weeks. Methods Women were randomised to intervention (dietary counselling twice by phone and access to twice-weekly exercise groups during pregnancy) or control group (standard prenatal care). Intervention compliance was defined post-factum as attending dietary counselling and ≥14 exercise classes. Main outcome measures PPWR (weight measured postpartum minus self-reported pre-…
Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial
Abstract Objective Excessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy. Results A total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water …
Changes in beverage consumption from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study.
AbstractObjectiveTo describe changes in consumption of different types of beverages from pre-pregnancy to early pregnancy, and to examine associations with maternal age, educational level and BMI.DesignCross-sectional design. Participants answered an FFQ at inclusion into a randomized controlled trial, the Fit for Delivery (FFD) trial, in median gestational week 15 (range: 9–20), reporting current consumption and in retrospect how often they drank the different beverages pre-pregnancy.SettingEight local antenatal clinics in southern Norway from September 2009 to February 2013.SubjectsFive hundred and seventy-five healthy pregnant nulliparous women.ResultsPre-pregnancy, 27 % reported drinkin…
Changes in mode of transportation to work or school from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study
Objective To describe changes in mode of transportation to work or school from pre-pregnancy to early pregnancy, to describe levels of physical activity related to mode of transportation to work or school, and to examine associations between changes in mode of transportation to work or school and educational level, body mass index (BMI) and age. Methods Between September 2009 and February 2013, 575 healthy pregnant nulliparous women were included into the Norwegian Fit for Delivery (NFFD) trial. At inclusion they reported their current and their pre-pregnancy mode of transportation to work or school. Data were analysed by multilevel mixed models with dichotomized modes of transportation as …
Changes in fruit and vegetable consumption habits from pre-pregnancy to early pregnancy among Norwegian women
Background: A healthy diet is important for pregnancy outcome and the current and future health of woman and child. The aims of the study were to explore the changes from pre-pregnancy to early pregnancy in consumption of fruits and vegetables (FV), and to describe associations with maternal educational level, body mass index (BMI) and age. Methods: Healthy nulliparous women were included in the Norwegian Fit for Delivery (NFFD) trial from September 2009 to February 2013, recruited from eight antenatal clinics in southern Norway. At inclusion, in median gestational week 15 (range 9–20), 575 participants answered a food frequency questionnaire (FFQ) where they reported consumption of FV, bot…
Identifying women with gestational diabetes based on maternal characteristics: an analysis of four Norwegian prospective studies
Abstract Background There is still no worldwide agreement on the best diagnostic thresholds to define gestational diabetes (GDM) or the optimal approach for identifying women with GDM. Should all pregnant women perform an oral glucose tolerance test (OGTT) or can easily available maternal characteristics, such as age, BMI and ethnicity, indicate which women to test? The aim of this study was to assess the prevalence of GDM by three diagnostic criteria and the predictive accuracy of commonly used risk factors. Methods We merged data from four Norwegian cohorts (2002–2013), encompassing 2981 women with complete results from a universally offered OGTT. Prevalences were estimated based on the f…
Pre-pregnancy and early pregnancy dietary behavior in relation to maternal and newborn health in the Norwegian Fit for Delivery study – a post hoc observational analysis
Background Randomized controlled trials targeting maternal dietary and physical activity behaviors during pregnancy have generally failed to accomplish reductions in the prevalence of adverse maternal and neonatal outcomes. Interventions carried out during pregnancy could thus be missing the mark in maximizing intervention health benefit. Objective To investigate whether pre-pregnancy and early pregnancy dietary behavior as reported at inclusion into the Norwegian Fit for Delivery (NFFD) trial was associated with maternal and neonatal outcomes irrespective of subsequent randomization assignment. Design The study is a post-hoc observational analysis of data from a randomized controlled lifes…
Study protocol: fit for delivery - can a lifestyle intervention in pregnancy result in measurable health benefits for mothers and newborns? A randomized controlled trial
Abstract Background The global obesity epidemic has led to increased attention on pregnancy, a period when women are at risk of gaining excessive weight. Excessive gestational weight gain is associated with numerous complications, for both mother and child. Though the problem is widespread, few studies have examined the effect of a lifestyle intervention in pregnancy designed to limit maternal weight gain. The Fit for Delivery study will explore the effectiveness of nutritional counseling coupled with exercise classes compared with standard prenatal care. The aims of the study are to examine the effect of the intervention on maternal weight gain, newborn birth weight, glucose regulation, co…
The effect of a prenatal lifestyle intervention on glucose metabolism: Results of the Norwegian Fit for Delivery randomized controlled trial
Background: The effectiveness of prenatal lifestyle intervention to prevent gestational diabetes and improve maternal glucose metabolism remains to be established. The Norwegian Fit for Delivery (NFFD) randomized, controlled trial studied the effect of a combined lifestyle intervention provided to a general population, and found significantly lower gestational weight gain among intervention participants but no improvement in obstetrical outcomes or the proportion of large infants. The aim of the present study is to examine the effect of the NFFD intervention on glucose metabolism, including an assessment of the subgroups of normal-weight and overweight/obese participants. Methods: Healthy, …
Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women
Abstract Sanda B, Vistad I, Haakstad LAH, Berntsen S, Sagedal LR, Lohne-Seiler H, Torstveit MK. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. Background The International Physical Activity Questionnaire short-form (IPAQ-SF) is frequently used to assess physical activity (PA) level in the general adult population including pregnant women. However, the reliability and validity of the questionnaire in pregnancy is unknown. Therefore, the aims of the present study were to investigate test-retest reliability and concurrent validity of IPAQ-SF among pregnant women, and whether PA is reported differently among those who fu…
Family meal participation is associated with dietary intake among 12-month-olds in Southern Norway
Abstract Background Family meal participation is associated with healthier eating among children and adolescents. Less is known about family meal participation among infants and toddlers. The objective of the present study was to explore whether family meal participation at 12 months of age is associated with dietary intake and whether a potential relationship differs according to maternal education or child sex. Methods Follow-up data from children born to mothers participating in the Norwegian Fit for Delivery (NFFD) trial during pregnancy were used to assess the frequency of intake of 11 dietary items according to frequency of participating in the respective family meals. Dietary differe…
Evaluation of implementing a community-based exercise intervention during pregnancy
Abstract Objective to evaluate the implementation of a community-based exercise intervention (the Norwegian Fit for Delivery study) during pregnancy. Design descriptive, explorative. Setting healthcare clinics in southern Norway, including urban and rural settings. Participants healthy, nulliparous women with singleton pregnancy of ≤20 gestational weeks, age ≥18 years and body mass index ≥19kg/m 2 . Methods women were randomised to either twice-weekly supervised exercise sessions combined with nutritional counselling ( n =303) or standard prenatal care ( n =303). The exercise program was based on ACOG guidelines, with the same low-impact workout for all participants, including 60minutes of …
Change in active transportation and weight gain in pregnancy
Background: Pregnancy is characterised by large weight gain over a short period, and often a notable change in mode of transportation. This makes pregnancy suitable for examining the plausible, but in the scientific literature still unclear, association between active transportation and weight gain. We hypothesize that women continuing an active mode of transportation to work or school from pre- to early pregnancy will have a lower gestational weight gain (GWG) than those who change to a less active mode of transportation. Methods: We analysed prospective data from the Norwegian Fit for Delivery (NFFD) trial. Between September 2009 and February 2013 606 women were consecutively enrolled in …
What is the effect of physical activity on duration and mode of delivery? Secondary analysis from the Norwegian Fit for Delivery trial
Introduction: The beneficial effects of physical activity during pregnancy for the mother and offspring have been reported by several studies but there are conflicting results concerning the possible effect of physical activity on the course of labor and risk of cesarean delivery. This study presents secondary analyses from the Norwegian Fit for Delivery randomized controlled trial, aiming at studying the effect of a lifestyle intervention including group exercise classes, as well as the possible influence of physical activity level in late pregnancy, on labor outcomes. Material and methods: Healthy nulliparous women with singleton pregnancy were randomized to an intervention group, n = 303…
Additional file 1 of Identifying women with gestational diabetes based on maternal characteristics: an analysis of four Norwegian prospective studies
Additional file 1. : Supporting information Table S1. Characteristics of study participants according to their glucose tolerance status, with three criteria (1999WHO, 2013WHO and 2017Norwegian criteria). Supporting information Table S2. Associations between maternal risk factors and gestational diabetes mellitus in univariate analysis and multivariate analysis, using the 1999WHO criteria.