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The impact of a lifestyle intervention on postpartum weight retention among at-risk Hispanic women
Palnati M, Marcus BH, Pekow P, Rosal MC, Manson JE, Chasan-Taber L
American Journal of Preventive Medicine 2021 Jul;61(1):44-54
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: This study assesses the impact of a culturally modified, motivationally targeted, individually tailored intervention on postpartum weight retention among Hispanic women with abnormal glucose tolerance during pregnancy. METHODS: Estudio Parto (project aiming to reduce type two diabetes) was an RCT conducted in Western Massachusetts (collected 2013 to 2017, analyzed 2018 to 2020). Hispanic women with blood glucose >= 140 mg/dL (7.77 mmol/L) on routine nonfasting oral glucose challenge test were randomized to a lifestyle intervention (n = 100) focusing on healthy exercise and diet or to a comparison health and wellness intervention (n = 104) with no mention of exercise or diet behavior changes. The primary outcome was change in weight, calculated as the difference between prepregnancy weight and 6-week, 6-month, and 12-month postpartum weight. The secondary outcome was achievement of weight reduction to prepregnancy weight if prepregnancy BMI was normal, or a 5% reduction if prepregnancy BMI was overweight/obese. RESULTS: In intent-to-treat analyses, there were no significant differences in weight change pattern between the intervention arms across all follow-up timepoints (beta 0.03, 95% CI -3.38 to 3.45). However, at 12 months postpartum, women in the Lifestyle Intervention arm had a statistically significant 2.5-fold higher odds of meeting the secondary weight reduction outcome (OR 2.52, 95% CI 1.09 to 5.82) than women in the health and wellness arm. Regardless of intervention arm, women who reported higher levels of postpartum sports/exercise had a greater decrease in weight (beta -2.39, 95% CI -4.66 to -0.13, p = 0.04) than women reporting lower levels. CONCLUSIONS: In this randomized trial among Hispanic women, no significant overall differences in weight change pattern between intervention arms were observed. Higher levels of self-reported physical activity were associated with greater weight loss in both arms.

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