Article Text
Abstract
Objective To study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.
Research design and methods A cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.
Results Ninety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2 vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), HbA1c in early pregnancy (6.7%±1.1% vs 6.5%±1.3% (50±12 mmol/mol vs 48±14 mmol/mol), p=0.32) and late pregnancy (5.9%±0.5% vs 6.0%±0.6% (41±6 mmol/mol vs 42±7 mmol/mol), p=0.34) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.
Conclusions Motivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.
Trial registration number NCT02883127.
- type 2 diabetes
- pregnancy
- weight gain
- Lifestyle Intervention(s)
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Footnotes
Contributors BÁ contributed to the idea, collected and researched the data, wrote the manuscript and contributed to the discussion. MV collected the data, contributed to the discussion and reviewed and edited the manuscript. LR, LLTA, and DMJ contributed to the discussion and reviewed and edited the manuscript. PD and ERM contributed to the idea and discussion and reviewed and edited the manuscript. ERM is the guarantor of this work and as such had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was supported by The Novo Nordisk Foundation.
Disclaimer The sponsor of the study was not involved in the design, conduct, or interpretation of the study.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The protocol was approved by the local ethical committee of the capital region of Denmark (H-15009413). The study was registered at ClinicalTrials.gov. All patients gave written informed consent as appropriate according to Danish laws. The principles of the Helsinki Declaration were followed.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.