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Cantor A, Jungbauer RM, McDonagh MS, et al. Counseling and Behavioral Interventions for Healthy Weight and Weight Gain in Pregnancy: A Systematic Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 May. (Evidence Synthesis, No. 203.)

Cover of Counseling and Behavioral Interventions for Healthy Weight and Weight Gain in Pregnancy: A Systematic Review for the U.S. Preventive Services Task Force

Counseling and Behavioral Interventions for Healthy Weight and Weight Gain in Pregnancy: A Systematic Review for the U.S. Preventive Services Task Force [Internet].

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Appendix ADetailed Methods

Appendix A1. Search Strategies

Ovid MEDLINE® Database Searches

Search Strategy:

  1. Pregnant Women/
  2. exp Pregnancy/
  3. perinatal care/ or prenatal care/
  4. (pregnan* or maternal or gestation* or perinatal or prenatal or antenatal or postpartum).ti,ab.
  5. or/1-4
  6. PRECONCEPTION CARE/
  7. (prepregnan* or preconception* or “pre-pregnan*” or “pre-conception”).ti,ab.
  8. 6 or 7
  9. Pregnancy Outcome/
  10. exp Pregnancy Complications/
  11. 9 or 10
  12. 5 or 8 or 11
  13. body weight/ or exp body weight changes/ or exp overweight/
  14. body mass index/
  15. (weight or overweight or obes* or BMI).ti,ab.
  16. 12 and (13 or 14 or 15)
  17. exp Life Style/
  18. exp Diet Therapy/
  19. exp Exercise/
  20. exp Physical Fitness/
  21. counseling/ or exp directive counseling/
  22. exp Behavior Therapy/
  23. exp Motivation/
  24. health behavior/ or risk reduction behavior/
  25. exp Patient Education as Topic/
  26. exp social support/
  27. health education/ or exp health promotion/
  28. (diet or exercise or lifestyle or “life style” or advice or advise or behavior* or behaviour* or nonpharma* or “non-pharma*”).ti,ab.
  29. or/17-28
  30. 16 and 29
  31. limit 30 to (english language and humans)
  32. limit 31 to (clinical trial, all or comparative study or controlled clinical trial or randomized controlled trial)
  33. 31 and (random* or control* or cohort or trial).ti,ab,kw.
  34. 32 or 33

Ovid MEDLINE® In-Process & Other Non-Indexed Citations

Search Strategy:

  1. (pregnan* or maternal or gestation* or perinatal or prenatal or antenatal or postpartum).ti,ab.
  2. (prepregnan* or preconception* or “pre-pregnan*” or “pre-conception”).ti,ab.
  3. (weight or overweight or obes* or BMI).ti,ab.
  4. (diet or exercise or lifestyle or “life style” or counsel* or advice or advise or behavior* or behaviour* or nonpharma* or “non-pharma*”).ti,ab.
  5. (1 or 2) and 3 and 4
  6. 5 and (random* or control* or trial or cohort).ti,ab,kw.

EBM Reviews - Cochrane Central Register of Controlled Trials

Search Strategy:

  1. Pregnant Women/
  2. exp Pregnancy/
  3. perinatal care/ or prenatal care/
  4. (pregnan* or maternal or gestation* or perinatal or prenatal or antenatal or postpartum).ti,ab.
  5. or/1-4
  6. PRECONCEPTION CARE/
  7. (prepregnan* or preconception* or “pre-pregnan*” or “pre-conception”).ti,ab.
  8. 6 or 7
  9. Pregnancy Outcome/
  10. exp Pregnancy Complications/
  11. 9 or 10
  12. 5 or 8 or 11
  13. body weight/ or exp body weight changes/ or exp overweight/
  14. body mass index/
  15. (weight or overweight or obes* or BMI).ti,ab.
  16. 12 and (13 or 14 or 15)
  17. exp Life Style/
  18. exp Diet Therapy/
  19. exp Exercise/
  20. exp Physical Fitness/
  21. counseling/ or exp directive counseling/
  22. exp Behavior Therapy/
  23. exp Motivation/
  24. health behavior/ or risk reduction behavior/
  25. exp Patient Education as Topic/
  26. exp social support/
  27. health education/ or exp health promotion/
  28. (diet or exercise or lifestyle or “life style” or advice or advise or behavior* or behaviour* or nonpharma* or “non-pharma*”).ti,ab.
  29. or/17-28
  30. 16 and 29
  31. limit 30 to english language

EBM Reviews - Cochrane Database of Systematic Reviews

Search Strategy:

  1. pregnan*,ti,ab.mp. [mp=title, short title, abstract, full text, keywords, caption text]
  2. (pregnant or pregnancy or gestation*).ti,ab.
  3. 2 and (weight or Overweight and obese or obesity).ti,ab.
  4. 3 and (diet or exercise or counsel* or advise or advise or behavior* of behaviour* or nonpharm* or “non-pharma*”).ti,ab.

PsycINFO

Search Strategy:

  1. exp Pregnancy/
  2. perinatal care/ or prenatal care/
  3. (pregnan* or maternal or gestation* or perinatal or prenatal or antenatal or postpartum).ti,ab.
  4. (prepregnan* or preconception* or “pre-pregnan*” or “pre-conception”).ti,ab.
  5. Pregnancy Outcome/
  6. body weight/ or exp body weight changes/ or exp overweight/
  7. body mass index/
  8. (weight or overweight or obes* or BMI).ti,ab.
  9. exp Exercise/
  10. exp Physical Fitness/
  11. counseling/ or exp directive counseling/
  12. exp Behavior Therapy/
  13. exp Motivation/
  14. health behavior/ or risk reduction behavior/
  15. exp social support/
  16. health education/ or exp health promotion/
  17. (diet or exercise or lifestyle or “life style” or counsel* or advice or advise or behavior* or behaviour* or nonpharma* or “non-pharma*”).ti,ab.
  18. (or/1-5) and (or/6-8)
  19. 18 and (or/9-17)
  20. 19 and (random* or control* or trial or cohort).ti,ab.

Appendix A2. Included and Excluded Criteria

IncludedExcluded
Population
  • Pregnant women with normal or high BMI
  • Women who are overweight and obese (defined by BMI) and planning pregnancy, including adolescents and adults
  • Studies limited to pregnant women with gestational diabetes mellitus
  • Women with preexisting diabetes
Intervention
  • Primary care–relevant interventions that aim to limit excess gestational weight gain or reduce prepregnancy weight, and focus on one or more of the following: diet, exercise, behavioral counseling
  • Conducted in or recruited from primary care or health care system, or could feasibly be implemented in or referred from primary care
  • Pharmacologic interventions
  • Broader community-based programs (e.g., mass media, changes to community-built environment)
OutcomeKQ1 – health outcomes:
  • Maternal or infant mortality (incl. stillbirth)
  • Maternal morbidity (e.g., postpartum hemorrhage, perineal trauma, depression)
  • Infant morbidity (e.g., birth trauma, shoulder dystocia, respiratory distress syndrome)
KQ2 – weight outcomes:
  • Preconception weight loss (kg or BMI)
  • Excessive gestational weight gain (per IOM recommendation or as described by authors)
  • Measured gestational weight gain (kg or BMI)
  • Maternal postpartum weight loss or retention
  • Incidence or prevalence of maternal obesity-related perinatal conditions (e.g., macrosomia, preterm birth, gestational diabetes mellitus, hypertension, cesarean delivery)
KQ3 – harms
  • Harms associated with interventions (e.g., anxiety, stigma, maternal musculoskeletal injuries)
  • Harms related to insufficient weight gain (e.g., ‘small for gestational age’ infants)
KQ1
  • Behavioral changes (e.g., physical activity level)
KQ2
  • Cardiometabolic measures (e.g., glucose level, blood pressure, lipid level)
Comparator
  • Interventions with a comparator or control group; for example:
    • No treatment (wait-list, usual care)
    • Attention control
    • Minimal intervention
Interventions without a control / comparator group
Study DesignKQ1-KQ3
  • Controlled clinical trial
KQ3
  • Cohort or case-control studies reporting harms related to interventions to reduce gestational weight gain and prepregnancy weight
All other study designs
Study QualityFair- or good-quality studiesPoor-quality studies
CountryCountries considered ‘very high’ on the 2016 Human Development IndexCountries not rated ‘very high’

Notes on Included/Excluded criteria

Mode of delivery: Interventions may be delivered via face-to-face contact, telephone, print materials, or technology (e.g., computer-based, text messages) and can be delivered by numerous potential providers (e.g., clinicians, nurses, exercise specialists, dietitians, nutritionists, behavioral health specialists, etc.)

Countries rated ‘very high’ on the 2016 HDI

  • Australia
  • Andorra
  • Argentina
  • Austria
  • Bahrain
  • Belgium
  • Brunei
  • Canada
  • Chile
  • Croatia
  • Cyprus
  • Czech Republic
  • Denmark
  • Estonia
  • Finland
  • France
  • Germany
  • Greece
  • Hong Kong
  • Hungary
  • Iceland
  • Ireland
  • Israel
  • Italy
  • Japan
  • South Korea
  • Kuwait
  • Latvia
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Malta
  • Montenegro
  • Netherlands
  • New Zealand
  • Norway
  • Poland
  • Portugal
  • Qatar
  • Romania
  • Russia
  • Saudi Arabia
  • Singapore
  • Slovakia
  • Slovenia
  • Spain
  • Sweden
  • Switzerland
  • U.K.
  • U.S.
  • U.A.E.

Appendix A3. Literature Flow Diagram

Appendix A3 is a literature flow diagram depicting the search and selection of articles for the review. The diagram shows that 8,511 citations were identified through literature database searches and other sources (including lists of relevant articles and systematic reviews, reviewer suggestions, etc.). 845 articles were reviewed at the full-text level after excluding 7,666 citations based on review of title and abstract. From the 845 articles reviewed for inclusion, 578 were excluded. Articles were excluded due to ineligible population (36); incorrect intervention (62); wrong outcome(s) (96); incorrect comparison (14); wrong publication type (161); wrong study design for KQ (109); non-English language (1); study conducted in country not on the ‘very high’ HDI list (17); companion paper with outdated data (13); systematic review or meta-analysis used as source document (55); sample size <50 (6); and poor quality (8). 68 studies in 87 publications were included that provide evidence for the key questions, organized as follows: maternal health outcomes (57); prepregnancy weight reduction (1); infant health outcomes (50); gestational weight gain outcomes (68); and harms (42). The number of included studies does not sum to the total listed because some trials are included in multiple key questions or subcategories.

*Some included publications are counted in multiple sections.

Note: Targeted searches for the contextual questions are not included in the current diagram.

Appendix A4. List of Included Studies

1.
Aguilar-Cordero MJ, Sanchez-Garcia JC, Rodriguez-Blanque R, et al. Moderate physical activity in an aquatic environment during pregnancy (SWEP Study) and its influence in preventing postpartum depression. J Am Psychiatr Nurses Assoc. 2019 Apr;25(2):112–21. doi: 10.1177/1078390317753675. PMID: 29490560. [PubMed: 29490560] [CrossRef]
2.
Al Wattar BH, Dodds J, Placzek A, et al. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): a pragmatic multicentre randomised trial. PLOS Medicine. 2019 Jul 23;16(7):e1002857. doi: 10.1371/journal.pmed.1002857. PMID: 31335871 [PMC free article: PMC6650045] [PubMed: 31335871] [CrossRef]
3.
Altazan AD, Redman LM, Burton JH, et al. Mood and quality of life changes in pregnancy and postpartum and the effect of a behavioral intervention targeting excess gestational weight gain in women with overweight and obesity: a parallel-arm randomized controlled pilot trial. BMC Pregnancy Childbirth. 2019 Jan 29;19(1):50. doi: 10.1186/s12884-019-2196-8. PMID: 30696408. [PMC free article: PMC6352352] [PubMed: 30696408] [CrossRef]
4.
Althuizen E, van der Wijden CL, van Mechelen W, et al. The effect of a counselling intervention on weight changes during and after pregnancy: a randomised trial. BJOG. 2013 Jan;120(1):92–9. doi: 10.1111/1471-0528.12014. PMID: 23121074. [PubMed: 23121074] [CrossRef]
5.
Asbee SM, Jenkins TR, Butler JR, et al. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009 Feb;113(2 Pt 1):305–12. doi: 10.1097/AOG.0b013e318195baef. PMID: 19155899. [PubMed: 19155899] [CrossRef]
6.
Assaf-Balut C, Garcia de la Torre N, Duran A, et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): a randomized controlled trial: the St. Carlos GDM prevention study. PLoS ONE. 2017 Oct 19;12(10):e0185873. doi: 10.1371/journal.pone.0185873. PMID: 29049303. [PMC free article: PMC5648128] [PubMed: 29049303] [CrossRef]
7.
Bacchi M, Mottola MF, Perales M, et al. Aquatic activities during pregnancy prevent excessive maternal weight gain and preserve birth weight: a randomized clinical trial. Am J Health Promot. 2018 Mar;32(3):729–35. doi: 10.1177/0890117117697520. PMID: 28279085. [PubMed: 28279085] [CrossRef]
8.
Barakat R, Cordero Y, Coteron J, et al. Exercise during pregnancy improves maternal glucose screen at 24-28 weeks: a randomised controlled trial. Br J Sports Med. 2012 Jul;46(9):656–61. doi: 10.1136/bjsports-2011-090009. PMID: 21948120. [PubMed: 21948120] [CrossRef]
9.
Barakat R, Franco E, Perales M, et al. Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2018 May;224:33–40. doi: 10.1016/j.ejogrb.2018.03.009. PMID: 29529475. [PubMed: 29529475] [CrossRef]
10.
Barakat R, Pelaez M, Cordero Y, et al. Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial. Am J Obstet Gynecol. 2016 May;214(5):649.e1–8. doi: 10.1016/j.ajog.2015.11.039. PMID: 26704894. [PubMed: 26704894] [CrossRef]
11.
Barakat R, Perales M, Bacchi M, et al. A program of exercise throughout pregnancy. Is it safe to mother and newborn? Am J Health Promot. 2014 Sep–Oct;29(1):2–8. doi: 10.4278/ajhp.130131-QUAN-56. PMID: 24200335. [PubMed: 24200335] [CrossRef]
12.
Barakat R, Refoyo I, Coteron J, et al. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther. 2019 Apr;23(2):148–55. doi: 10.1016/j.bjpt.2018.11.005. PMID: 30470666. [PMC free article: PMC6428908] [PubMed: 30470666] [CrossRef]
13.
Bogaerts AF, Devlieger R, Nuyts E, et al. Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial. Int J Obes (Lond). 2013 Jun;37(6):814–21. doi: 10.1038/ijo.2012.162. PMID: 23032404. [PubMed: 23032404] [CrossRef]
14.
Brownfoot FC, Davey MA, Kornman L. Routine weighing to reduce excessive antenatal weight gain: a randomised controlled trial. BJOG. 2016 Dec;123(2):254–61. doi: 10.1111/1471-0528.13735. PMID: 26840637. [PubMed: 26840637] [CrossRef]
15.
Bruno R, Petrella E, Bertarini V, et al. Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial. Matern Child Nutr. 2017 Jul;13(3) doi: 10.1111/mcn.12333. PMID: 27647837. [PMC free article: PMC6866030] [PubMed: 27647837] [CrossRef]
16.
Cahill AG, Haire-Joshu D, Cade WT, et al. Weight control program and gestational weight gain in disadvantaged women with overweight or obesity: a randomized clinical trial. Obesity (Silver Spring). 2018 Mar;26(3):485–91. doi: 10.1002/oby.22070. PMID: 29464907. [PMC free article: PMC5826625] [PubMed: 29464907] [CrossRef]
17.
Claesson IM, Josefsson A, Sydsjo G. Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study. BMC Public Health. 2010 Dec 16;10:766. doi: 10.1186/1471-2458-10-766. PMID: 21162715. [PMC free article: PMC3016389] [PubMed: 21162715] [CrossRef]
18.
Daley A, Jolly K, Jebb S, et al. Feasibility and acceptability of regular weighing, setting weight gain limits and providing feedback by community midwives to prevent excess weight gain during pregnancy: randomised controlled trial and qualitative study. BMC Obesity. 2015 Sep 16;2(1):35. doi: 10.1186/s40608-015-0061-5. PMID: 26401345. [PMC free article: PMC4572649] [PubMed: 26401345] [CrossRef]
19.
Daley A JKJSARAMLLACSUMOCKSMCAP. Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial. BMJ Open; 2019. p. e030174. [PMC free article: PMC6756421] [PubMed: 31530608]
20.
Daly N, Farren M, McKeating A, et al. A medically supervised pregnancy exercise intervention in obese women: a randomized controlled trial. Obstet Gynecol. 2017 Nov;130(5):1001–10. doi: 10.1097/AOG.0000000000002267. PMID: 29016485. [PubMed: 29016485] [CrossRef]
21.
Dodd JM, McPhee AJ, Deussen AR, et al. Effects of an antenatal dietary intervention in overweight and obese women on 6 month infant outcomes: follow-up from the LIMIT randomised trial. Int J Obes (Lond). 2018 Jul;42(7):1326–35. doi: 10.1038/s41366-018-0019-z. PMID: 29568100. [PMC free article: PMC6054603] [PubMed: 29568100] [CrossRef]
22.
Dodd JM, Turnbull D, McPhee AJ, et al. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. Br Med J. 2014 Feb 10;348:g1285. doi: 10.1136/bmj.g1285. PMID: 24513442. [PMC free article: PMC3919179] [PubMed: 24513442] [CrossRef]
23.
Dodd Jm DARLJ. A randomised trial to optimise gestational weight gain and improve maternal and infant health outcomes through antenatal dietary, lifestyle and exercise advice: the OPTIMISE randomised trial. Nutrients. 2019 Dec 02;11(12) doi: 10.3390/nu11122911. PMID: 31810217. [PMC free article: PMC6949931] [PubMed: 31810217] [CrossRef]
24.
Epel E, Laraia B, Coleman-Phox K, et al. Effects of a mindfulness-based intervention on distress, weight gain, and glucose control for pregnant low-income women: a quasi-experimental trial using the ORBIT model. Int J Behav Med. 2019 Apr 16;26(5):461–73. doi: 10.1007/s12529-019-09779-2. PMID: 30993601. [PMC free article: PMC6785577] [PubMed: 30993601] [CrossRef]
25.
Gallagher D, Rosenn B, Toro-Ramos T, et al. Greater neonatal fat-free mass and similar fat mass following a randomized trial to control excess gestational weight gain. Obesity (Silver Spring). 2018 Mar;26(3):578–87. doi: 10.1002/oby.22079. PMID: 29464905. [PMC free article: PMC5824435] [PubMed: 29464905] [CrossRef]
26.
Garnaes KK, Morkved S, Salvesen KA, et al. Exercise training during pregnancy reduces circulating insulin levels in overweight/obese women postpartum: secondary analysis of a randomised controlled trial (the ETIP trial). BMC Pregnancy Childbirth. 2018 Jan 08;18(1):18. doi: 10.1186/s12884-017-1653-5. PMID: 29310617. [PMC free article: PMC5759335] [PubMed: 29310617] [CrossRef]
27.
Garnaes KK, Morkved S, Salvesen O, et al. Exercise training and weight gain in obese pregnant women: a randomized controlled trial (ETIP trial). PLoS Med. 2016 Jul 26;13(7):e1002079. doi: 10.1371/journal.pmed.1002079. PMID: 27459375. [PMC free article: PMC4961392] [PubMed: 27459375] [CrossRef]
28.
Garnaes KK, Nyrnes SA, Salvesen KA, et al. Effect of supervised exercise training during pregnancy on neonatal and maternal outcomes among overweight and obese women. Secondary analyses of the ETIP trial: a randomised controlled trial. PLoS ONE. 2017 Mar 21;12(3):e0173937. doi: 10.1371/journal.pone.0173937. PMID: 28323893. [PMC free article: PMC5360254] [PubMed: 28323893] [CrossRef]
29.
Garnaes Kk HASSSNMSSKSOMT. Effects of supervised exercise training during pregnancy on psychological well-being among overweight and obese women: secondary analyses of the ETIP-trial, a randomised controlled trial. BMJ Open. 2019;9(11) doi: 10.1136/bmjopen-2018-028252. PMID: 31753866. [PMC free article: PMC6886967] [PubMed: 31753866] [CrossRef]
30.
Gesell SB, Katula JA, Strickland C, et al. Feasibility and initial efficacy evaluation of a community-based cognitive-behavioral lifestyle intervention to prevent excessive weight gain during pregnancy in Latina women. Matern Child Health J. 2015 Aug;19(8):1842–52. doi: 10.1007/s10995-015-1698-x. PMID: 25874878. [PMC free article: PMC4500842] [PubMed: 25874878] [CrossRef]
31.
Gray-Donald K, Robinson E, Collier A, et al. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. CMAJ. 2000 Nov 14;163(10):1247–51. PMID: 11107459. [PMC free article: PMC80308] [PubMed: 11107459]
32.
Guelfi KJ, Ong MJ, Crisp NA, et al. Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial. 2016 Oct;128(4):819–27. doi: 10.1097/aog.0000000000001632. PMID: 27607876 [PubMed: 27607876] [CrossRef]
33.
Haakstad LA, Bo K. Effect of regular exercise on prevention of excessive weight gain in pregnancy: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2011 Apr;16(2):116–25. doi: 10.3109/13625187.2011.560307. PMID: 21417561. [PubMed: 21417561] [CrossRef]
34.
Haire-Joshu D, Cahill AG, Stein RI, et al. Randomized controlled trial of home-based lifestyle therapy on postpartum weight in underserved women with overweight or obesity. Obes. 2019 Apr;27(4):535–41. doi: 10.1002/oby.22413. PMID: 30900408. [PMC free article: PMC6526535] [PubMed: 30900408] [CrossRef]
35.
Harrison CL, Lombard CB, Strauss BJ, et al. Optimizing healthy gestational weight gain in women at high risk of gestational diabetes: a randomized controlled trial. Obesity (Silver Spring). 2013 May;21(5):904–9. doi: 10.1002/oby.20163. PMID: 23784892. [PubMed: 23784892] [CrossRef]
36.
Harrison CL, Lombard CB, Teede HJ. Limiting postpartum weight retention through early antenatal intervention: the HeLP-her randomised controlled trial. Int J Behav Nutr Phys Act. 2014 Oct 31;11(134) doi: 10.1186/s12966-014-0134-8. PMID: 25358909. [PMC free article: PMC4221718] [PubMed: 25358909] [CrossRef]
37.
Hawkins M, Hosker M, Marcus BH, et al. A pregnancy lifestyle intervention to prevent gestational diabetes risk factors in overweight Hispanic women: a feasibility randomized controlled trial. Diabet Med. 2014 Oct;32(1):108–15. doi: 10.1111/dme.12601. PMID: 25306925. [PubMed: 25306925] [CrossRef]
38.
Herring SJ, Cruice JF, Bennett GG, et al. Intervening during and after pregnancy to prevent weight retention among African American women. Prev Med Rep. 2017 Jun 1;7:119–23. doi: 10.1016/j.pmedr.2017.05.015. PMID: 28660118. [PMC free article: PMC5479961] [PubMed: 28660118] [CrossRef]
39.
Herring SJ, Cruice JF, Bennett GG, et al. Preventing excessive gestational weight gain among African American women: a randomized clinical trial. Obesity (Silver Spring). 2016 Jan;24(1):30–6. doi: 10.1002/oby.21240. PMID: 26592857. [PMC free article: PMC4688057] [PubMed: 26592857] [CrossRef]
40.
Hoffmann J, Gunther J, Stecher L, et al. Effects of a lifestyle intervention in routine care on short- and long-term maternal weight retention and breastfeeding behavior-12 months follow-up of the cluster-randomized GeliS trial. J Clin Med. 2019 Jun 19;8(6):19. doi: 10.3390/jcm8060876. PMID: 31248138. [PMC free article: PMC6616390] [PubMed: 31248138] [CrossRef]
41.
Hui A, Back L, Ludwig S, et al. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG. 2012 Jan;119(1):70–7. doi: 10.1111/j.1471-0528.2011.03184.x. PMID: 22017967. [PubMed: 22017967] [CrossRef]
42.
Hui AL, Back L, Ludwig S, et al. Effects of lifestyle intervention on dietary intake, physical activity level, and gestational weight gain in pregnant women with different pre-pregnancy body mass index in a randomized control trial. BMC Pregnancy Childbirth. 2014 Sep 24;14(331) doi: 10.1186/1471-2393-14-331. PMID: 25248797. [PMC free article: PMC4287470] [PubMed: 25248797] [CrossRef]
43.
Huvinen E, Koivusalo SB, Meinila J, et al. Effects of a lifestyle intervention during pregnancy and first postpartum year: findings from the RADIEL study. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1669–77. doi: 10.1210/jc.2017-02477. PMID: 29409025. [PubMed: 29409025] [CrossRef]
44.
Kinnunen TI, Raitanen J, Aittasalo M, et al. Preventing excessive gestational weight gain--a secondary analysis of a cluster-randomised controlled trial. Eur J Clin Nutr. 2012 Dec;66(12):1344–50. doi: 10.1038/ejcn.2012.146. PMID: 23211656. [PubMed: 23211656] [CrossRef]
45.
Koivusalo SB, Rono K, Klemetti MM, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial.[Erratum appears in Diabetes Care. 2017 Jun 14;:; PMID: 28615238]. Diabetes Care. 2016 Jan;39(1):24–30. doi: 10.2337/dc15-0511. PMID: 26223239. [PubMed: 26223239] [CrossRef]
46.
Kunath J, Gunther J, Rauh K, et al. Effects of a lifestyle intervention during pregnancy to prevent excessive gestational weight gain in routine care - the cluster-randomised GeliS trial. BMC Med. 2019 Jan 14;17(5) doi: 10.1186/s12916-018-1235-z. PMID: 30636636. [PMC free article: PMC6330753] [PubMed: 30636636] [CrossRef]
47.
Leblanc ES, Smith NX, Vesco KK, et al. Weight loss prior to pregnancy and subsequent gestational weight gain: prepare, a randomized clinical trial. Am J Obstet Gynecol. 2020 Jul 17. doi: 10.1016/j.ajog.2020.07.027. PMID: 32687819. [PubMed: 32687819] [CrossRef]
48.
Luoto R, Kinnunen TI, Aittasalo M, et al. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial. PLoS Med. 2011 May;8(5):e1001036. doi: 10.1371/journal.pmed.1001036. PMID: 21610860. [PMC free article: PMC3096610] [PubMed: 21610860] [CrossRef]
49.
Magriples U, Boynton MH, Kershaw TS, et al. The impact of group prenatal care on pregnancy and postpartum weight trajectories. Am J Obstet Gynecol. 2015 Nov;213(5):688.e1–9. doi: 10.1016/j.ajog.2015.06.066. PMID: 26164694. [PMC free article: PMC4910388] [PubMed: 26164694] [CrossRef]
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McCarthy EA, Walker SP, Ugoni A, et al. Self-weighing and simple dietary advice for overweight and obese pregnant women to reduce obstetric complications without impact on quality of life: a randomised controlled trial. BJOG. 2016 May;123(6):965–73. doi: 10.1111/1471-0528.13919. PMID: 26875586. [PubMed: 26875586] [CrossRef]
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McGiveron A, Foster S, Pearce J, et al. Limiting antenatal weight gain improves maternal health outcomes in severely obese pregnant women: findings of a pragmatic evaluation of a midwife-led intervention. J Hum Nutr Diet. 2015 Jan;28: Suppl 1:29–37. doi: 10.1111/jhn.12240. PMID: 24809211. [PubMed: 24809211] [CrossRef]
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Okesene-Gafa KAM, Li M, McKinlay CJD, et al. Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial. Am J Obstet Gynecol. 2019 Mar 13:pii. doi: 10.1016/j.ajog.2019.03.003. PMID: 30878323. [PubMed: 30878323] [CrossRef]
53.
Olson CM, Groth SW, Graham ML, et al. The effectiveness of an online intervention in preventing excessive gestational weight gain: the e-moms roc randomized controlled trial. BMC Pregnancy Childbirth. 2018 May 9;18(148) doi: 10.1186/s12884-018-1767-4. PMID: 29743026. [PMC free article: PMC5944067] [PubMed: 29743026] [CrossRef]
54.
Peccei A, Blake-Lamb T, Rahilly D, et al. Intensive prenatal nutrition counseling in a community health setting: a randomized controlled trial. Obstet Gynecol. 2017 Aug;130(2):423–32. doi: 10.1097/AOG.0000000000002134. PMID: 28697099. [PubMed: 28697099] [CrossRef]
55.
Pelaez M, Gonzalez-Cerron S, Montejo R, et al. Protective effect of exercise in pregnant women including those who exceed weight gain recommendations: a randomized controlled trial. Mayo Clin Proc. 2019 Oct;94(10):1951–9. doi: 10.1016/j.mayocp.2019.01.050. PMID: 31585579. [PubMed: 31585579] [CrossRef]
56.
Perales M, Rodríguez YC, Terrones MV, et al. Exercise and depression in overweight and obese pregnant women: a randomised controlled trial. Archivos de medicina del deporte: revista de la Federación Española de Medicina del Deporte y de la Confederación Iberoamericana de Medicina del Deporte. 2015(167):156–63.
57.
Petrella E, Malavolti M, Bertarini V, et al. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program. J Matern Fetal Neonatal Med. 2014 Sep;27(13):1348–52. doi: 10.3109/14767058.2013.858318. PMID: 24175912. [PubMed: 24175912] [CrossRef]
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Phelan S, Phipps MG, Abrams B, et al. Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the fit for delivery randomized trial. Am J Clin Nutr. 2014 Feb;99(2):302–11. doi: 10.3945/ajcn.113.070151. PMID: 24284438. [PMC free article: PMC3893723] [PubMed: 24284438] [CrossRef]
59.
Phelan S, Phipps MG, Abrams B, et al. Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: the fit for delivery study. Am J Clin Nutr. 2011 Apr;93(4):772–9. doi: 10.3945/ajcn.110.005306. PMID: 21310836. [PMC free article: PMC3057546] [PubMed: 21310836] [CrossRef]
60.
Phelan S, Wing RR, Brannen A, et al. Does partial meal replacement during pregnancy reduce 12-month postpartum weight retention? Obes. 2019 Feb;27(2):226–36. doi: 10.1002/oby.22361. PMID: 30421864. [PMC free article: PMC8142600] [PubMed: 30421864] [CrossRef]
61.
Phelan S, Wing RR, Brannen A, et al. Randomized controlled clinical trial of behavioral lifestyle intervention with partial meal replacement to reduce excessive gestational weight gain. Am J Clin Nutr. 2018 Feb 1;107(2):183–94. doi: 10.1093/ajcn/nqx043. PMID: 29529157. [PMC free article: PMC6455030] [PubMed: 29529157] [CrossRef]
62.
Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord. 2002 Nov;26(11):1494–502. doi: 10.1038/sj.ijo.0802130. PMID: 12439652. [PubMed: 12439652] [CrossRef]
63.
Rauh K, Gabriel E, Kerschbaum E, et al. Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial. BMC Pregnancy Childbirth. 2013 Jul 16;13(151) doi: 10.1186/1471-2393-13-151. PMID: 23865624. [PMC free article: PMC3718707] [PubMed: 23865624] [CrossRef]
64.
Rauh K, Gunther J, Kunath J, et al. Lifestyle intervention to prevent excessive maternal weight gain: mother and infant follow-up at 12 months postpartum. BMC Pregnancy Childbirth. 2015 Oct 15;15(265) doi: 10.1186/s12884-015-0701-2. PMID: 26472133. [PMC free article: PMC4608142] [PubMed: 26472133] [CrossRef]
65.
Redman LM, Gilmore LA, Breaux J, et al. Effectiveness of SmartMoms, a novel eHealth intervention for management of gestational weight gain: randomized controlled pilot trial. JMIR Mhealth Uhealth. 2017 Sep 13;5(9):e133. doi: 10.2196/mhealth.8228. PMID: 28903892. [PMC free article: PMC5617906] [PubMed: 28903892] [CrossRef]
66.
Renault KM, Norgaard K, Nilas L, et al. The Treatment of Obese Pregnant women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol. 2014 Feb;210(2):134.e1–9. doi: 10.1016/j.ajog.2013.09.029. PMID: 24060449. [PubMed: 24060449] [CrossRef]
67.
Ronnberg AK, Ostlund I, Fadl H, et al. Intervention during pregnancy to reduce excessive gestational weight gain-a randomised controlled trial. BJOG. 2014 Nov;122(4):537–44. doi: 10.1111/1471-0528.13131. PMID: 25367823. [PubMed: 25367823] [CrossRef]
68.
Rönö K, Grotenfelt NE, Klemetti M, et al. Effect of a lifestyle intervention during pregnancy-findings from the Finnish gestational diabetes prevention trial (RADIEL). J Perinatol. 2018b Sep;38(9):1157–64. doi: 10.1038/s41372-018-0178-8 PMID: 30042471 [PubMed: 30042471] [CrossRef]
69.
Rönö K, Stach-Lempinen B, Eriksson JG, et al. Prevention of gestational diabetes with a prepregnancy lifestyle intervention - findings from a randomized controlled trial. Int J Women Health. 2018a Aug 27;10:493–501. doi: 10.2147/IJWH.S162061. PMID: 30214318. [PMC free article: PMC6118269] [PubMed: 30214318] [CrossRef]
70.
Ruiz JR, Perales M, Pelaez M, et al. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc. 2013 Dec;88(12):1388–97. doi: 10.1016/j.mayocp.2013.07.020. PMID: 24290112. [PubMed: 24290112] [CrossRef]
71.
Sagedal LR, Overby NC, Bere E, et al. Lifestyle intervention to limit gestational weight gain: the Norwegian fit for delivery randomised controlled trial. BJOG. 2017 Jan;124(1):97–109. doi: 10.1111/1471-0528.13862. PMID: 26768233. [PubMed: 26768233] [CrossRef]
72.
Sagedal LR, Sanda B, Overby NC, et al. The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian fit for delivery randomised controlled trial. BJOG. 2017b Jan;124(1):111–21. doi: 10.1111/1471-0528.13863. PMID: 26786294. [PubMed: 26786294] [CrossRef]
73.
Seneviratne SN, Jiang Y, Derraik J, et al. Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial. BJOG. 2016 Mar;123(4):588–97. doi: 10.1111/1471-0528.13738. PMID: 26542419. [PubMed: 26542419] [CrossRef]
74.
Simmons D, Devlieger R, van Assche A, et al. Effect of physical activity and/or healthy eating on GDM risk: the DALI lifestyle study. J Clin Endocrinol Metab. 2017 Mar 1;102(3):903–13. doi: 10.1210/jc.2016-3455. PMID: 27935767. [PMC free article: PMC5460688] [PubMed: 27935767] [CrossRef]
75.
Skouteris H, McPhie S, Hill B, et al. Health coaching to prevent excessive gestational weight gain: a randomized-controlled trial. Br J Health Psychol. 2016 Feb;21(1):31–51. doi: 10.1111/bjhp.12154. PMID: 26227112. [PubMed: 26227112] [CrossRef]
76.
Smith K, Lanningham-Foster L, Welch A, et al. Web-based behavioral intervention increases maternal exercise but does not prevent excessive gestational weight gain in previously sedentary women. J Phys Act Health. 2016 Jun;13(6):587–93. doi: 10.1123/jpah.2015-0219. PMID: 26594820. [PubMed: 26594820] [CrossRef]
77.
Tanvig M, Vinter CA, Jorgensen JS, et al. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years: results from the Lifestyle in Pregnancy and Offspring (LiPO) study. J Clin Endocrinol Metab. 2015 Jan;100(1):175–83. doi: 10.1210/jc.2014-2675. PMID: 25343235. [PubMed: 25343235] [CrossRef]
78.
Tanvig M, Vinter CA, Jorgensen JS, et al. Anthropometrics and body composition by dual energy X-ray in children of obese women: a follow-up of a randomized controlled trial (the Lifestyle in Pregnancy and Offspring [LiPO] study). PLoS ONE. 2014 Feb 24;9(2):e89590. doi: 10.1371/journal.pone.0089590. PMID: 24586896. [PMC free article: PMC3933548] [PubMed: 24586896] [CrossRef]
79.
Thomson JL, Goodman MH, Tussing-Humphreys LM, et al. Infant growth outcomes from birth to 12 months of age: findings from the delta healthy sprouts randomized comparative impact trial. Obes Sci Pract. 2018 Aug;4(4):299–307. doi: 10.1002/osp4.272. PMID: 30151225 [PMC free article: PMC6105708] [PubMed: 30151225] [CrossRef]
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Thomson JL, Tussing-Humphreys LM, Goodman MH, et al. Gestational weight gain: results from the Delta Healthy Sprouts comparative impact trial. J Pregnancy. 2016 Jul 12;2016(5703607) doi: 10.1155/2016/5703607. PMID: 27595023. [PMC free article: PMC4993958] [PubMed: 27595023] [CrossRef]
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Van Horn L, Peaceman A, Kwasny M, et al. Dietary approaches to stop hypertension diet and activity to limit gestational weight: maternal offspring metabolics family intervention trial, a technology enhanced randomized trial. Am J Prev Med. 2018 Nov;55(5):603–14. doi: 10.1016/j.amepre.2018.06.015. PMID: 30262148 [PubMed: 30262148] [CrossRef]
82.
Vesco KK, Karanja N, King JC, et al. Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial. Obesity (Silver Spring). 2014 Sep;22(9):1989–96. doi: 10.1002/oby.20831. PMID: 25164259. [PMC free article: PMC4407817] [PubMed: 25164259] [CrossRef]
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Vesco KK, Leo MC, Karanja N, et al. One-year postpartum outcomes following a weight management intervention in pregnant women with obesity. Obesity (Silver Spring). 2016 Oct;24(10):2042–9. doi: 10.1002/oby.21597. PMID: 27670399. [PMC free article: PMC5084910] [PubMed: 27670399] [CrossRef]
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Vinter CA, Jensen DM, Ovesen P, et al. The LiP (Lifestyle in Pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care. 2011 Dec;34(12):2502–7. doi: 10.2337/dc11-1150. PMID: 21972411. [PMC free article: PMC3220844] [PubMed: 21972411] [CrossRef]
85.
Vinter CA, Jensen DM, Ovesen P, et al. Postpartum weight retention and breastfeeding among obese women from the randomized controlled Lifestyle in Pregnancy (LiP) trial. Acta Obstet Gynecol Scand. 2014 Aug;93(8):794–801. doi: 10.1111/aogs.12429. PMID: 24834792. [PubMed: 24834792] [CrossRef]
86.
Willcox JC, Wilkinson SA, Lappas M, et al. A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial. BJOG. 2017 Oct;124(11):1718–28. doi: 10.1111/1471-0528.14552. PMID: 28220604. [PubMed: 28220604] [CrossRef]
87.
Wolff S, Legarth J, Vangsgaard K, et al. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). 2008 Mar;32(3):495–501. doi: 10.1038/sj.ijo.0803710. PMID: 18227847. [PubMed: 18227847] [CrossRef]

Appendix A5. List of Excluded Studies

1.
ACOG. Nutrition during pregnancy. ACOG Technical Bulletin Number 179--April 1993. Int J Gynaecol Obstet. 1993 Oct;43(1):67–74. doi: 10.1016/0020-7292(93)90281-Z. PMID: 7904962. Exclusion: wrong publication type. [PubMed: 7904962] [CrossRef]
2.
Adam LM, Jarman M, Barker M, et al. Use of healthy conversation skills to promote healthy diets, physical activity and gestational weight gain: results from a pilot randomised controlled trial. Patient Educ Couns. 2020 Jul. doi: 10.1016/j.pec.2020.01.001. Exclusion: wrong intervention. [PubMed: 32035738] [CrossRef]
3.
Adamo KB, Ferraro ZM, Brett KE. Can we modify the intrauterine environment to halt the intergenerational cycle of obesity? Int J Environ Res Public Health. 2012 Apr;9(4):1263–307. doi: 10.3390/ijerph9041263. PMID: 22690193. Exclusion: wrong publication type. [PMC free article: PMC3366611] [PubMed: 22690193] [CrossRef]
4.
Adamo KB, Ferraro ZM, Goldfield G, et al. The Maternal Obesity Management (MOM) trial protocol: a lifestyle intervention during pregnancy to minimize downstream obesity. Contemp Clin Trials. 2013 May;35(1):87–96. doi: 10.1016/j.cct.2013.02.010. PMID: 23459089. Exclusion: wrong publication type. [PubMed: 23459089] [CrossRef]
5.
Adane AA, Tooth LR, Mishra GD. Pre-pregnancy weight change and incidence of gestational diabetes mellitus: a finding from a prospective cohort study. Diabetes Res Clin Pract. 2017 Feb;124:72–80. doi: 10.1016/j.diabres.2016.12.014. PMID: 28110238. Exclusion: wrong intervention. [PubMed: 28110238] [CrossRef]
6.
Adesegun D, Cai C, Sivak A, et al. Prenatal exercise and pre-gestational diseases: a systematic review and meta-analysis. J Obstet Gynaecol Can. 2018 Dec 28;41(8):1134–43. doi: 10.1016/j.jogc.2018.10.007. PMID: 30598427. Exclusion: systematic review or meta-analysis used only as a source document for pearling. [PubMed: 30598427] [CrossRef]
7.
Agricola E, Pandolfi E, Gonfiantini MV, et al. A cohort study of a tailored web intervention for preconception care. BMC Med Inf Decis Mak. 2014 Apr 15;14(33) doi: 10.1186/1472-6947-14-33. PMID: 24731520. Exclusion: wrong outcome. [PMC free article: PMC4021543] [PubMed: 24731520] [CrossRef]
8.
Aguilera M, Sidebottom AC, McCool BR. Examination of routine use of prenatal weight gain charts as a communication tool for providers. Matern Child Health J. 2017 Oct;21(10):1927–38. doi: 10.1007/s10995-017-2308-x. PMID: 28707103. Exclusion: wrong outcome. [PubMed: 28707103] [CrossRef]
9.
Ainscough K, Kennelly M, Lindsay KL, et al. Impact of an mHealth supported healthy lifestyle intervention on behavioural stage of change in overweight and obese pregnancy. Proc Nutr Soc. 2016;Conference: summer meeting. 2016: new technology in nutrition research and practice. Ireland 75(OCE3):E85. Exclusion: wrong publication type.
10.
Ainscough K, Kennelly M, O’Sullivan E, et al. Impact of an mHealth-supported behavioural lifestyle intervention on exercise stage-of-change and physical activity in overweight and obese pregnancy: pEARs randomised controlled trial (RCT). BJOG. Conference: 19th annual conference of the british maternal and fetal medicine society, BMFMS. 2017;124:96–7. Exclusion: wrong publication type.
11.
Ainscough K, Kennelly MA, O’Sullivan EJ, et al. Impact of a smartphone app supporting a lifestyle intervention in overweight and obese pregnancy on on maternal health and lifestyle outcomes. Am J Obstet Gynecol. 2018;Conference: 38th annual meeting of the society for maternal-fetal medicine: the pregnancy meeting. United states. 218(1 Supplement 1):S598–S9. Exclusion: wrong publication type.
12.
Ainscough KM, Kennelly MA, O’Sullivan EJ, et al. Impact of an mhealth-supported behavioral lifestyle intervention on behavioral stage of change and physical activity in overweight and obese pregnancy: pears randomized controlled trial. Reprod Sci. 2017;Conference: 64th annual scientific meeting of the society for gynecologic investigation, SGI. 2017. United states 24(1 Supplement 1):186A. Exclusion: wrong publication type.
13.
Ainscough KM, Lindsay KL, Gibney ER, et al. A review of the integration of behaviour change methodologies in randomised controlled trial lifestyle interventions among overweight and obese women during pregnancy. Obes Facts. 2016;9(207). Exclusion: wrong publication type.
14.
Al Wattar BH. Mediterranean-style diet in pregnancies with metabolic risk factors (ESTEEM): a pragmatic multicente. Int J Gynaecol Obstet. 2018;143:192. doi: 10.1371/journal.pmed.1002857. PMID: 31335871. Exclusion: wrong publication type. [CrossRef]
15.
Al Wattar BH, Mylrea-Lowndes B, Moore A, et al. Dietary assessment methods in pregnancy: a systematic review of literature. BJOG. 2015;122(254). Exclusion: wrong publication type.
16.
Al Wattar BH, Mylrea-Lowndes B, Morgan C, et al. Use of dietary assessment tools in randomized trials evaluating diet-based interventions in pregnancy: a systematic review of literature. Curr Opin Obstet Gynecol. 2016 Dec;28(6):455–63. doi: 10.1097/GCO.0000000000000322. PMID: 27755129. Exclusion: systematic review or meta-analysis used only as a source document for pearling. [PubMed: 27755129] [CrossRef]
17.
Allen R, Rogozinska E, Sivarajasingam P, et al. Effect of diet- and lifestyle-based metabolic risk-modifying interventions on preeclampsia: a meta-analysis. Acta Obstet Gynecol Scand. 2014 Oct;93(10):973–85. doi: 10.1111/aogs.12467. PMID: 25138651. Exclusion: systematic review or meta-analysis used only as a source document for pearling. [PubMed: 25138651] [CrossRef]
18.
Al-Ofi EA, Mosli HH, Ghamri KA, et al. Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system. J Int Med Res. 2019 Feb;47(2):754–64. doi: 10.1177/0300060518809872. PMID: 30442052. Exclusion: wrong population. [PMC free article: PMC6381491] [PubMed: 30442052] [CrossRef]
19.
Anand SS, Gupta M, Teo KK, et al. Causes and consequences of gestational diabetes in South Asians living in Canada: results from a prospective cohort study. CMAJ Open. 2017 Aug 9;5(3):E604–E11. doi: 10.9778/cmajo.20170027. PMID: 28800568. Exclusion: wrong intervention. [PMC free article: PMC5621966] [PubMed: 28800568] [CrossRef]
20.
Anderson LN, Knight JA, Hung RJ, et al. The Ontario Birth Study: a prospective pregnancy cohort study integrating perinatal research into clinical care. Paediatr Perinat Epidemiol. 2018 May;32(3):290–301. doi: 10.1111/ppe.12473. PMID: 29750375. Exclusion: wrong intervention. [PubMed: 29750375] [CrossRef]
21.
Angel MD, De Haene J, Perez M, et al. Dietary patterns associated with gestational weight gain and fat mass gain in overweight and obese pregnant women. Faseb J. 2011;25(9). Exclusion: wrong study design.
22.
Anleu E, Reyes M, Araya BM, et al. Effectiveness of an intervention of dietary counseling for overweight and obese pregnant women in the consumption of sugars and energy. Nutrients. 2019 Feb 13;11(2):13. doi: 10.3390/nu11020385. PMID: 30781781. Exclusion: wrong outcome. [PMC free article: PMC6412784] [PubMed: 30781781] [CrossRef]
23.
AprOn, Teams ES. Adherence to Canada’s food guide recommendations during pregnancy: nutritional epidemiology and public health. Curr Dev Nutr. 2017 Jul;1(7):e000356. doi: 10.3945/cdn.116.000356. PMID: 29955709. Exclusion: wrong outcome. [PMC free article: PMC5998351] [PubMed: 29955709] [CrossRef]
24.
Arden MA, Duxbury AM, Soltani H. Responses to gestational weight management guidance: a thematic analysis of comments made by women in online parenting forums. BMC Pregnancy Childbirth. 2014 Jun 30;14(216) doi: 10.1186/1471-2393-14-216. PMID: 24981024. Exclusion: wrong publication type. [PMC free article: PMC4091654] [PubMed: 24981024] [CrossRef]
25.
Arendas K, Qiu Q, Gruslin A. Obesity in pregnancy: pre-conceptional to postpartum consequences. J Obstet Gynaecol Can. 2008 Jun;30(6):477–88. doi: 10.1016/S1701-2163(16)32863-8. PMID: 18611299. Exclusion: wrong publication type. [PubMed: 18611299] [CrossRef]
26.
Arianas EA, Rankin KM, Norr KF, et al. Maternal weight status and responsiveness to preterm infant behavioral cues during feeding. BMC Pregnancy Childbirth. 2017 Apr 11;17(113) doi: 10.1186/s12884-017-1298-4. PMID: 28399825. Exclusion: wrong population. [PMC free article: PMC5387281] [PubMed: 28399825] [CrossRef]
27.
Arinze NV, Karp SM, Gesell SB. Evaluating provider advice and women’s beliefs on total weight gain during pregnancy. J Immigr Minor Health. 2016 Feb;18(1):282–6. doi: 10.1007/s10903-015-0162-8. PMID: 25649967. Exclusion: wrong intervention. [PMC free article: PMC4715834] [PubMed: 25649967] [CrossRef]
28.
Daily weight monitoring in pregnancy-a randomised controlled trial. Aust N Z J Obstet Gynaecol; 2016. 56. Exclusion: wrong comparator.
29.
Asci O, Rathfisch G. Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial. J Health Popul Nutr. 2016 Feb 24;35(7) doi: 10.1186/s41043-016-0044-2. PMID: 26911204. Exclusion: wrong country. [PMC free article: PMC5025976] [PubMed: 26911204] [CrossRef]
30.
Babbar S, Porter BW, Williams KB. The impact of prenatal yoga on exercise attitudes and behavior: teachable moments from a randomized controlled trial. In J Yoga Therap. 2017 Nov;27(1):37–48. doi: 10.17761/IJYT2017_Research_Babbar_Epub. PMID: 29131740. Exclusion: wrong outcome. [PubMed: 29131740] [CrossRef]
31.
Badon SE, Enquobahrie DA, Wartko PD, et al. Healthy lifestyle during early pregnancy and risk of gestational diabetes mellitus. Am J Epidemiol. 2017 Aug 1;186(3):326–33. doi: 10.1093/aje/kwx095. PMID: 28481961. Exclusion: wrong study design. [PMC free article: PMC5860043] [PubMed: 28481961] [CrossRef]
32.
Badon SE, Littman AJ, Chan KCG, et al. Maternal sedentary behavior during pre-pregnancy and early pregnancy and mean offspring birth size: a cohort study. BMC Pregnancy Childbirth. 2018 Jun 27;18(267) doi: 10.1186/s12884-018-1902-2. PMID: 29945548. Exclusion: wrong intervention. [PMC free article: PMC6020429] [PubMed: 29945548] [CrossRef]
33.
Bain E, Crane M, Tieu J, et al. Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2015 Apr 12(4):CD010443. doi: 10.1002/14651858.CD010443.pub2. PMID: 25864059. Exclusion: systematic review or meta-analysis used only as a source document for pearling. [PubMed: 25864059] [CrossRef]
34.
Bannon AL, Waring ME, Leung K, et al. Comparison of self-reported and measured pre-pregnancy weight: implications for gestational weight gain counseling. Matern Child Health J. 2017 Jul;21(7):1469–78. doi: 10.1007/s10995-017-2266-3. PMID: 28155023. Exclusion: wrong study design. [PubMed: 28155023] [CrossRef]
35.
Bao H, Yu P, Song X, et al. The influence of home-based exercise on gestational diabetes: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2019 Jan 09:1–6. doi: 10.1080/14767058.2018.1548595. PMID: 30626247. Exclusion: systematic review or meta-analysis used only as a source document for pearling. [PubMed: 30626247] [CrossRef]
36.
Bao W, Tobias DK, Olsen SF, et al. Pre-pregnancy fried food consumption and the risk of gestational diabetes mellitus: a prospective cohort study. Diabetologia. 2014 Dec;57(12):2485–91. doi: 10.1007/s00125-014-3382-x. PMID: 25303998. Exclusion: wrong outcome. [PMC free article: PMC4221538] [PubMed: 25303998] [CrossRef]
37.
Barakar R, Pelaez M, Lopez C, et al. Exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Ann Nutr Metab. 2013;63:723–4. Exclusion: wrong publication type.
38.
Barakat R, Lucia A, Ruiz JR. Resistance exercise training during pregnancy and newborn’s birth size: a randomised controlled trial. Int J Obes (Lond). 2009 Sep;33(9):1048–57. doi: 10.1038/ijo.2009.150. PMID: 19636320. Exclusion: wrong outcome. [PubMed: 19636320] [CrossRef]
39.
Barakat R, Pelaez M, Lopez C, et al. Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial. Br J Sports Med. 2013 Jul;47(10):630–6. doi: 10.1136/bjsports-2012-091788. PMID: 23365418. Exclusion: wrong outcome. [PubMed: 23365418] [CrossRef]
40.
Barakat R, Perales M, Cordero Y, et al. Influence of land or water exercise in pregnancy on outcomes: a cross-sectional study. Med Sci Sports Exerc. 2017 Jul;49(7):1397–403. doi: 10.1249/MSS.0000000000001234. PMID: 28198729. Exclusion: wrong study design. [PubMed: 28198729] [CrossRef]
41.
Barden A, Singh R, Walters B, et al. A simple scoring method using cardiometabolic risk measurements in pregnancy to determine 10-year risk of type 2 diabetes in women with gestational diabetes. Nutr Diabetes. 2013 Jun 3;3(6):e72. doi: 10.1038/nutd.2013.15. PMID: 23732679. Exclusion: wrong intervention. [PMC free article: PMC3697403] [PubMed: 23732679] [CrossRef]
42.
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197.
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198.
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199.
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200.
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201.
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202.
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203.
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204.
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205.
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206.
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207.
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208.
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209.
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210.
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211.
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212.
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213.
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214.
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215.
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216.
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217.
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218.
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219.
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220.
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221.
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222.
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223.
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224.
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225.
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226.
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227.
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228.
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229.
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230.
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231.
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232.
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233.
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234.
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235.
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236.
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237.
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238.
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239.
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240.
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241.
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242.
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243.
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244.
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245.
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246.
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247.
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248.
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249.
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250.
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251.
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252.
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253.
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254.
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255.
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256.
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257.
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258.
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259.
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260.
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261.
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262.
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263.
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264.
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265.
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266.
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267.
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268.
Hui AL, Back L, Reid A, et al. Effects of physical activity and dietary intakes on weight gain of pregnant women with normal and above normal prepregnancy weight. Can J Diabetes. START: 2012 Oct 10 CONFERENCE END: 2012 Oct 13, 15th Annual Canadian Diabetes Association/Canadian Society of Endocrinology and Metabolism Professional Conference and Annual Meetings Vancouver, BC Canada;36(5 SUPPL. 1):S8. Exclusion: wrong publication type.
269.
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270.
Hui AL, Ludwig SM, Gardiner P, et al. Community-based exercise and dietary intervention during pregnancy: a pilot study. Can J Diabetes. 2006;30(2):169–75. doi: 10.1016/S1499-2671(06)02010-7. Exclusion: inadequate sample size. [CrossRef]
271.
Huvinen H, Koivusalo S, StachLempinen B, et al. Effects of a lifestyle intervention during pregnancy and 1-year postpartum -results from the RADIEL study. Gynecol Endocrinol. Conference: 17th world congress of gynaecological endocrinology, ISGE. 2016;32(161). Exclusion: wrong publication type.
272.
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273.
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Appendix A6. U.S. Preventive Services Task Force Quality Rating Criteria

Randomized Controlled Trials (RCTs) and Cohort Studies

Criteria:

  • Initial assembly of comparable groups:
    • For RCTs: Adequate randomization, including first concealment and whether potential confounders were distributed equally among groups
    • For cohort studies: Consideration of potential confounders, with either restriction or measurement for adjustment in the analysis; consideration of inception cohorts
  • Maintenance of comparable groups (includes attrition, cross-overs, adherence, contamination)
  • Important differential loss to followup or overall high loss to followup
  • Measurements: equal, reliable, and valid (includes masking of outcome assessment)
  • Clear definition of interventions
  • All important outcomes considered
  • Analysis: adjustment for potential confounders for cohort studies or intention-to treat analysis for RCTs

Definition of ratings based on above criteria:

Good: Meets all criteria: Comparable groups are assembled initially and maintained throughout the study (followup ≥80%); reliable and valid measurement instruments are used and applied equally to all groups; interventions are spelled out clearly; all important outcomes are considered; and appropriate attention to confounders in analysis. In addition, intention-to-treat analysis is used for RCTs.

Fair: Studies are graded “fair” if any or all of the following problems occur, without the fatal flaws noted in the “poor” category below: Generally comparable groups are assembled initially, but some question remains whether some (although not major) differences occurred with followup; measurement instruments are acceptable (although not the best) and generally applied equally; some but not all important outcomes are considered; and some but not all potential confounders are accounted for. Intention-to-treat analysis is used for RCTs.

Poor: Studies are graded “poor” if any of the following fatal flaws exists: Groups assembled initially are not close to being comparable or maintained throughout the study; unreliable or invalid measurement instruments are used or not applied equally among groups (including not masking outcome assessment); and key confounders are given little or no attention. Intention-to-treat analysis is lacking for RCTs.

Source: Procedure Manual. U.S. Preventive Services Task Force.

https://www.uspreventiveservicestaskforce.org/Page/Name/appendix-vi-criteria-for-assessing-internal-validity-of-individual-studies Accessed on 4/12/19.

Appendix A7. Expert Reviewers of the Draft Report

Patrick Catalano MD, Vice Chair of Obstetrics & Gynecology Research; Professor, Tufts University School of Medicine

Rebecca Clifton PhD, Associate Research Professor, Milken Institute School of Public Health, George Washington University; Co-Investigator, Maternal Fetal Medicine Units Network, NICHD

Alan Peaceman MD, Chief of Maternal Fetal Medicine, Professor, Department of Obstetrics and Gynecology, Northwestern University

Scott K. Winiecki MD, Director, Safe Use Initiative, Professional Affairs and Stakeholder Engagement Staff, Center for Drug Evaluation and Research, U.S. Food and Drug Administration

Brandy Peaker MD, MPH, Medical Advisor, Office of Public Health Scientific Services, Division of Public Health Information Dissemination, CDC

Gretchen Buckler MD, MPH, CDR, USPHS Commissioned Corps Medical Officer, Clinical Research Office of Research on Women’s Health (ORWH)

Elena Gorodetsky MD, PhD, Health Scientist Administrator/Research Program Officer, Office of Research on Women’s Health (ORWH)

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