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

*Corresponding author for this work

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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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. (2019). Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease. Pregnancy Hypertension, 15, 98-107. https://doi.org/10.1016/j.preghy.2018.12.004