Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease

D. Berks, M. Hoedjes, H. Raat, A. Franx, C.w.n. Looman, M.f. Van Oostwaard, D.n.m. Papatsonis, J.j. Duvekot, E.a.p. Steegers

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objectives
To evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease.

Methods
Women following a complicated pregnancy were included six months postpartum in this specific pre-post controlled designed study. It has been conducted in one tertiary and three secondary care hospitals (intervention group) and one secondary care hospital (control group). The program consisted of a computer-tailored health education program combined with three individual counselling sessions during seven months. Primary outcome measures were the proportion of eligible women and weight change during the intervention.

Results
Two hundred and six women were willing to participate. The proportion of eligible women who complied with the intervention was 23%. Major barrier was lack of time.

Adjusted weight change attributed to lifestyle intervention was −1.9 kg (95%-CI −4.3 to −0.3). Further changes were BMI (-0.9 kg/m2 (95%-CI −1.4 to −0.3)), waist-to-hip ratio (−0.04 cm/cm (95%-CI −0.06 to −0.03)), blood pressure medication use (19% (95%-CI 9% to 28%)), HOMA2-score (59 %S (95%-CI 18 to 99)) and total fat intake (−2.9 gr (95%-CI −4.6 to −1.2)).

Conclusions
The results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. Further randomized controlled studies are needed with longer follow-up to evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.
Original languageEnglish
Pages (from-to)98-107
JournalPregnancy Hypertension
Volume15
DOIs
Publication statusPublished - 2019

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Mothers
Weights and Measures
Fats
Delivery of Health Care

Keywords

  • CARDIOVASCULAR RISK
  • DESIGN
  • DISORDERS
  • HYPERTENSION
  • PREECLAMPSIA
  • PREVENTION
  • QUESTIONNAIRE
  • SOCIETY
  • WEIGHT
  • WOMEN

Cite this

Berks, D. ; Hoedjes, M. ; Raat, H. ; Franx, A. ; Looman, C.w.n. ; Van Oostwaard, M.f. ; Papatsonis, D.n.m. ; Duvekot, J.j. ; Steegers, E.a.p. / Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease. In: Pregnancy Hypertension. 2019 ; Vol. 15. pp. 98-107.
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title = "Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease",
abstract = "ObjectivesTo evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease.MethodsWomen following a complicated pregnancy were included six months postpartum in this specific pre-post controlled designed study. It has been conducted in one tertiary and three secondary care hospitals (intervention group) and one secondary care hospital (control group). The program consisted of a computer-tailored health education program combined with three individual counselling sessions during seven months. Primary outcome measures were the proportion of eligible women and weight change during the intervention.ResultsTwo hundred and six women were willing to participate. The proportion of eligible women who complied with the intervention was 23{\%}. Major barrier was lack of time.Adjusted weight change attributed to lifestyle intervention was −1.9 kg (95{\%}-CI −4.3 to −0.3). Further changes were BMI (-0.9 kg/m2 (95{\%}-CI −1.4 to −0.3)), waist-to-hip ratio (−0.04 cm/cm (95{\%}-CI −0.06 to −0.03)), blood pressure medication use (19{\%} (95{\%}-CI 9{\%} to 28{\%})), HOMA2-score (59 {\%}S (95{\%}-CI 18 to 99)) and total fat intake (−2.9 gr (95{\%}-CI −4.6 to −1.2)).ConclusionsThe results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. Further randomized controlled studies are needed with longer follow-up to evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.",
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author = "D. Berks and M. Hoedjes and H. Raat and A. Franx and C.w.n. Looman and {Van Oostwaard}, M.f. and D.n.m. Papatsonis and J.j. Duvekot and E.a.p. Steegers",
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language = "English",
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Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease. / Berks, D.; Hoedjes, M.; Raat, H.; Franx, A.; Looman, C.w.n.; Van Oostwaard, M.f.; Papatsonis, D.n.m.; Duvekot, J.j.; Steegers, E.a.p.

In: Pregnancy Hypertension, Vol. 15, 2019, p. 98-107.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease

AU - Berks, D.

AU - Hoedjes, M.

AU - Raat, H.

AU - Franx, A.

AU - Looman, C.w.n.

AU - Van Oostwaard, M.f.

AU - Papatsonis, D.n.m.

AU - Duvekot, J.j.

AU - Steegers, E.a.p.

PY - 2019

Y1 - 2019

N2 - ObjectivesTo evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease.MethodsWomen following a complicated pregnancy were included six months postpartum in this specific pre-post controlled designed study. It has been conducted in one tertiary and three secondary care hospitals (intervention group) and one secondary care hospital (control group). The program consisted of a computer-tailored health education program combined with three individual counselling sessions during seven months. Primary outcome measures were the proportion of eligible women and weight change during the intervention.ResultsTwo hundred and six women were willing to participate. The proportion of eligible women who complied with the intervention was 23%. Major barrier was lack of time.Adjusted weight change attributed to lifestyle intervention was −1.9 kg (95%-CI −4.3 to −0.3). Further changes were BMI (-0.9 kg/m2 (95%-CI −1.4 to −0.3)), waist-to-hip ratio (−0.04 cm/cm (95%-CI −0.06 to −0.03)), blood pressure medication use (19% (95%-CI 9% to 28%)), HOMA2-score (59 %S (95%-CI 18 to 99)) and total fat intake (−2.9 gr (95%-CI −4.6 to −1.2)).ConclusionsThe results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. Further randomized controlled studies are needed with longer follow-up to evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.

AB - ObjectivesTo evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease.MethodsWomen following a complicated pregnancy were included six months postpartum in this specific pre-post controlled designed study. It has been conducted in one tertiary and three secondary care hospitals (intervention group) and one secondary care hospital (control group). The program consisted of a computer-tailored health education program combined with three individual counselling sessions during seven months. Primary outcome measures were the proportion of eligible women and weight change during the intervention.ResultsTwo hundred and six women were willing to participate. The proportion of eligible women who complied with the intervention was 23%. Major barrier was lack of time.Adjusted weight change attributed to lifestyle intervention was −1.9 kg (95%-CI −4.3 to −0.3). Further changes were BMI (-0.9 kg/m2 (95%-CI −1.4 to −0.3)), waist-to-hip ratio (−0.04 cm/cm (95%-CI −0.06 to −0.03)), blood pressure medication use (19% (95%-CI 9% to 28%)), HOMA2-score (59 %S (95%-CI 18 to 99)) and total fat intake (−2.9 gr (95%-CI −4.6 to −1.2)).ConclusionsThe results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. Further randomized controlled studies are needed with longer follow-up to evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.

KW - CARDIOVASCULAR RISK

KW - DESIGN

KW - DISORDERS

KW - HYPERTENSION

KW - PREECLAMPSIA

KW - PREVENTION

KW - QUESTIONNAIRE

KW - SOCIETY

KW - WEIGHT

KW - WOMEN

U2 - 10.1016/j.preghy.2018.12.004

DO - 10.1016/j.preghy.2018.12.004

M3 - Article

VL - 15

SP - 98

EP - 107

JO - Pregnancy Hypertension

JF - Pregnancy Hypertension

SN - 2210-7789

ER -