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Vogel L, Färber T, Hölzl I, Deliens T, Henning C, Liel C, Löchner J, Lux U, Opitz A, Seiferth C, Versele V, Wolstein J, van Poppel MNM. I-PREGNO - prevention of unhealthy weight gain and psychosocial stress in families during pregnancy and postpartum using an mHealth enhanced intervention: a study protocol of two cluster randomized controlled trials. BMC Pregnancy Childbirth 2023; 23:418. [PMID: 37280529 DOI: 10.1186/s12884-023-05735-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The transition to parenthood represents a critical life period with psychosocial, and behavioral changes and challenges for parents. This often increases stress and leads to unhealthy weight gain in families, especially in psychosocially burdened families. Although universal and selective prevention programs are offered to families, specific support often fails to reach psychosocially burdened families. Digital technologies are a chance to overcome this problem by enabling a low-threshold access for parents in need. However, there is currently a lack of smartphone-based interventions that are tailored to the needs of psychosocially burdened families. AIMS The research project I-PREGNO aims to develop and evaluate a self-guided, smartphone-based intervention in combination with face-to-face counseling delivered by healthcare professionals for the prevention of unhealthy weight gain and psychosocial problems. The intervention is specifically tailored to the needs of psychosocially burdened families during the pregnancy and postpartum period. METHODS In two cluster randomized controlled trials in Germany and Austria (N = 400) psychosocially burdened families will be recruited and randomized to i) treatment as usual (TAU), or ii) I-PREGNO intervention (self-guided I-PREGNO app with counseling sessions) and TAU. We expect higher acceptance and better outcomes on parental weight gain and psychosocial stress in the intervention group. DISCUSSION The intervention offers a low cost and low-threshold intervention and considers the life situation of psychosocially burdened families who are a neglected group in traditional prevention programs. After positive evaluation, the intervention may easily be implemented in existing perinatal care structures in European countries such as Germany and Austria. TRIAL REGISTRATION Both trials were registered prospectively at the German Clinical Trials Register (Germany: DRKS00029673; Austria: DRKS00029934) in July and August 2022.
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Affiliation(s)
- Lea Vogel
- Department of Psychology, LMU Munich, Munich, Germany.
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany.
| | - Tanja Färber
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Ingrid Hölzl
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Tom Deliens
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Carmen Henning
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Christoph Liel
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy Tuebingen, Tuebingen, Germany
| | - Ulrike Lux
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Ansgar Opitz
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Caroline Seiferth
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Vicka Versele
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Medicine, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jörg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
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Zhang S, Qiu X, Qin J, Song X, Liu Y, Wei J, Sun M, Shu J, Wang T, Chen L, Jiang Y. Effects of Maternal Pre-Pregnancy BMI and Gestational Weight Gain on the Development of Preeclampsia and Its Phenotypes: A Prospective Cohort Study in China. J Clin Med 2022; 11:jcm11195521. [PMID: 36233388 PMCID: PMC9571777 DOI: 10.3390/jcm11195521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/18/2022] [Accepted: 09/18/2022] [Indexed: 11/16/2022] Open
Abstract
Preeclampsia (PE) is a common and serious pregnancy-specific disorder, which is closely linked with adverse maternal and neonatal outcomes. This study aimed to evaluate whether maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) was associated with preeclampsia and its phenotypes. In this prospective study, 32,531 women with singleton pregnancies were finally included. Compared with women with normal pre-pregnancy BMI, women with overweight and obesity were at increased risk of PE (RR = 1.62, 95%CI: 1.57−1.66; RR = 2.04, 95%CI: 1.97−2.11, respectively), while those who were underweight had a lower risk of PE (RR = 0.84, 95%CI: 0.81−0.88). When compared with women who gained adequate GWG, pregnant women with inadequate GWG and excessive GWG had an increased risk of PE (RR = 1.15, 95%CI: 1.12−1.19; RR = 1.56, 95%CI: 1.52−1.60, respectively). The observed increased risk was generally similar for mild-, severe-, early- and late-onset PE, and the reduced risk was similar for severe- and late-onset PE. No significant interactions between GWG and pre-pregnancy BMI on the risk of PE were identified (p-interaction > 0.05). In conclusion, pre-pregnancy overweight or obesity and excessive GWG have established risk factors for PE, and that the potential risk may vary according to PE phenotypes. Moreover, the synergistic effect that may exist between pre-pregnancy BMI and GWG.
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Affiliation(s)
- Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Xing Qiu
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Xingli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Yiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Jing Shu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
- National Health Commission Key Laboratory for Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410028, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
- Correspondence: (L.C.); (Y.J.); Tel.: +86-135-1749-2008 (L.C.); +86-130-0731-4171 (Y.J.)
| | - Yurong Jiang
- Department of Obstetrics, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410028, China
- Correspondence: (L.C.); (Y.J.); Tel.: +86-135-1749-2008 (L.C.); +86-130-0731-4171 (Y.J.)
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Liney T, Shah NM, Singh N. Recurrent gestational diabetes : Breaking the transgenerational cycle with lifestyle modification. Wien Klin Wochenschr 2022; 134:788-798. [PMID: 35147773 DOI: 10.1007/s00508-022-02004-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE This literature review is aimed at examining the benefits of lifestyle modifications in preventing recurrent gestational diabetes (GDM). Worldwide GDM affects approximately 16.2% of all pregnancies with significant maternal, fetal and neonatal complications. Almost two thirds of pregnant women with GDM will develop type 2 diabetes mellitus (T2DM) in the years following pregnancy. The proportion of women affected by GDM is on the rise and reflects increasing trends in T2DM as well as adult and childhood obesity. METHODS Using predefined subject headings, we searched for relevant articles from the PubMed, Scopus, and Cochrane databases. RESULTS For high-risk women lifestyle modifications, such as dietary and exercise changes, are the mainstay of treatment to reduce negative outcomes for both women and their pregnancies. This includes reducing the incidence of recurrent GDM and future T2DM by intervening during pregnancy and in the postnatal period. CONCLUSION This review provides an overview of the literature to date, discusses different targeted approaches and how these interventions can optimise their benefits, and where further research is required.
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Affiliation(s)
- Thomas Liney
- The Hillingdon Hospitals NHS Foundation Trust, Pield Heath Road, UB8 3NN, Uxbridge, UK
| | - Nishel M Shah
- Imperial College London, Academic Department of Obstetrics & Gynaecology, Level 3, Chelsea and Westminster Hospital, 369 Fulham Road, SW10 9NH, London, UK
| | - Natasha Singh
- Imperial College London, Academic Department of Obstetrics & Gynaecology, Level 3, Chelsea and Westminster Hospital, 369 Fulham Road, SW10 9NH, London, UK.
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Li C, Cai Y, Li Y, Peng B, Liu Y, Wang Z, Yang T, Hu Y, Fu Y, Shi T, Peng H, Zhang Y, Chen J, Li T, Chen L. Well-controlled gestational diabetes mellitus without pharmacologic therapy decelerates weight gain in infancy. Front Endocrinol (Lausanne) 2022; 13:1063989. [PMID: 36601002 PMCID: PMC9807162 DOI: 10.3389/fendo.2022.1063989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
AIM There are no prospective longitudinal studies on the association between well-controlled gestational diabetes mellitus (GDM) without pharmacologic therapy and the physical growth of offspring in infancy. We aimed to identify the trajectories in physical growth (from 0-12 months of age) in the offspring of mothers with well-controlled GDM without pharmacologic therapy in a prospective cohort in China. METHODS This study included 236 offspring of mothers with GDM and 369 offspring of mothers without GDM. Mothers with GDM were not on pharmacologic therapy. The length and weight of infants were measured at 0, 1, 3, 6, and 12 months. Linear mixed-effect models and linear mixed-effect models were applied. RESULTS The fully adjusted model showed that the weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and BMI-for-age z-score (BMIZ) were similar at birth for the GDM and control groups. However, subsequent increases in WAZ and BMIZ for the GDM group lagged the increases for the control group at the subsequent periods of observation, 0-1, 0-6, and 0-12 months. CONCLUSIONS Well-controlled GDM without pharmacologic therapy may normalize physical growth of offspring at birth and decelerate their weight gain in infancy. Whether glycemic control can mitigate the long-term effects of GDM on the growth trajectory in offspring remains unclear.
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Affiliation(s)
- Chao Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yixi Cai
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yinying Li
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Bin Peng
- School of Public Health and Management, Department of Health Statistics, Chongqing Medical University, Chongqing, China
| | - Yongfang Liu
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Zhenming Wang
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Ting Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Yirong Hu
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yajun Fu
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Tingmei Shi
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Hong Peng
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yue Zhang
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Jie Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Tingyu Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Li Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- *Correspondence: Li Chen, ;;
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