Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled trial

妊娠准备生活方式干预 (LIPP) 的原理和研究设计:一项随机对照试验

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作者:M L Erickson, J T Mey, C L Axelrod, D Paul, L Gordesky, K Russell, H Barkoukis, P O'Tierney-Ginn, R A Fielding, J P Kirwan, P M Catalano

Discussion

This RCT will determine the efficacy of maternal weight loss prior to pregnancy on reducing neonatal adiposity. Findings may change standard obstetrical care by providing Level 1 evidence on lifestyle interventions improving neonatal outcomes for women planning for pregnancy. Clinical

Material and methods

Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. Primary outcomes: Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. Secondary outcomes: Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation.

Methods

Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. Primary outcomes: Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. Secondary outcomes: Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation.

Trial registration

NCT03146156.

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