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Title: Impact of preconception weight loss on fasting glucose and pregnancy outcomes in women with obesity: A randomized trial.
Austin Authors: Price, Sarah A L;Sumithran, Priya ;Nankervis, Alison J;Permezel, Michael;Prendergast, Luke A;Proietto, Joseph 
Affiliation: Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
Medicine (University of Melbourne)
Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
Mercy Hospital for Women, Heidelberg
Issue Date: Sep-2021
Publication information: Obesity 2021; 29(9): 1445-1457
Abstract: This study examined the effectiveness of a nonsurgical, preconception weight loss intervention on pregnancy outcomes in women with obesity. This was a two-arm, parallel-group randomized controlled trial. A total of 164 women with BMI 30 to 55 kg/m2 who were aged 18 to 38 years and planning pregnancy were randomized to a 12-week standard dietary intervention (SDI; n = 79) or a modified very low-energy diet (VLED; n = 85). Participants were observed for ≤48 weeks while trying for pregnancy and then during pregnancy. The primary outcome was maternal fasting plasma glucose at 26 to 28 weeks' gestation. Exploratory outcomes were individual and composite obesity-related adverse pregnancy outcomes. Weight loss was greater in the VLED group (SDI 3.2 [0.6] kg vs. VLED 13.0 [0.5] kg, p < 0.01). In completers who had a singleton live birth (SDI 22/79 vs. VLED 35/85, p = 0.10), there was no difference in fasting glucose at 26 to 28 weeks' gestation (SDI 4.8[0.2] mmol/L vs. VLED 4.6 [0.1] mmol/L, p = 0.42). However, the composite of adverse pregnancy outcomes was significantly lower in the VLED group (p < 0.001). Substantial prepregnancy weight loss in women with obesity does not alter fasting glucose at 26 to 28 weeks' gestation but does reduce a composite of adverse pregnancy outcomes. A better understanding of metabolic changes in pregnancy after preconception weight loss may assist in improving maternal and neonatal health outcomes.
DOI: 10.1002/oby.23200
ORCID: 0000-0001-7722-3171
Journal: Obesity
PubMed URL: 34431233
Type: Journal Article
Subjects: Pregnancy
Appears in Collections:Journal articles

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