Author/year | Country | Design | Population | Recruitment | Intervention type | Description | Quality | Risk of bias |
---|---|---|---|---|---|---|---|---|
Asbee, 2009 [18] | USA | RCT | n = 100 All BMI categories (< 40.5 kg/m2), age 18-49 years | wk 6-16 of gestation | 1. diet + PA counseling 2. usual care | Individual session with a dietician only at 1st visit. Diet should consist of 40% CH, 30% protein and 30% fat. GWG monitored at every visit. Moderate exercise 3-5 times/wk. | Randomization: A Allocation: A Blinding: B Losses: A | moderate |
Badrawi, 1992 [37] | Egypt | RCT | n = 100 Obese multiparous women, age 25-35 years | early in pregnancy | 1. caloric restriction 2. usual care | Usual care: Normal diet according to WHO energy recommendations (2300-3000 kcal/day). Intervention: balanced low-energy diet (1500-2000 kcal/day). | Randomization: A Allocation: B Blinding: B Losses: B | moderate |
Campbell, 1975 [19] | Scotland | QCT | n = 102 Primiparous women with high GWG (> 570 g/wk) at 20-30 weeks gestation | wk 30 of gestation | 1. caloric restriction 2. usual care 3. diuretics* | A low-energy diet (1200 kcal/day) with low CH. The second intervention group was excluded, due to use of drugs as part of the intervention. | Randomization: B Allocation: C Blinding: B Losses: B | high |
Campbell 1982 [38] | Scotland | QCT | n = 182 Obese primiparous women | wk 29-30 of gestation | 1. caloric restriction 2. usual care | A low-energy diet (1250 kcal/day), instructed by a dietitian at recruitment | Randomization: B Allocation: C Blinding: B Losses: B | high |
Guelinckx, 2009 [20] | Belgium | RCT | n = 122 White, obese pregnant women, BMI > 29 | < wk 15 of gestation | 1. brochure 2. brochure + diet + PA counseling 3. usual care | Intervention 1: Given a purpose design brochure at 1st prenatal consultation, with nutritional and PA advice to limit GWG according to IOM guidelines. Intervention 2: Brochure + active lifestyle education by a nutritionist in 3 1 hour group sessions. All participants: Nutritional habits evaluated every trimester with three 7-day food records. | Randomization: A Allocation: A Blinding: C Losses: C | high |
Huang, 2009 [21] | Taiwan | RCT | n = 125 Pregnant women ≥ 18 years of age | < 16 wk of gestation | 1. diet + PA counseling + brochure during pregnancy 2. diet + PA counseling + brochure given postpartum* 3. usual care | Usual care: Routine obstetric educational program, once each trimester. Intervention 1: 6 individual session with a dietician with individualized diet and PA plan + brochure, from recruitment to 6 months post partum. | Randomization: A Allocation: A Blinding: A Losses: C | high |
Hui, 2006 [39] | Canada | RCT | n = 45 Pregnant women with no preexisting diabetes | < 26 wk of gestation | 1. diet + PA counseling 2. usual care | Usual care: information package on diet and PA for a healthy pregnancy. Intervention: Group and home based exercises (3-5 times/wk for 30-45 min was recommended). They also received Computer assisted Food Choice Map, dietary interviews and counseling. | Randomization: A Allocation: B Blinding: B Losses: A | moderate |
Ilmonen, 2010 [22] | Finland | RCT | n = 171 | < 17 wk of gestation | 1. diet + placebo 2. diet + probiotics* 3. usual care + placebo | Intervention groups: Dietary counseling (nutritionist) + probiotic or placebo capsules and food products for home use, each trimester and at 1, 6 and 12 months post partum. Diet should consist of 55-60% CH, 10-15% protein and 30% fat. | Randomization: A Allocation: A Blinding: A Losses: C | high |
Kinnunen, 2007 [23] | Finland | QCT | n = 105 Normal weight primiparous women ≥ 18 years | < 8-9 wk of gestation | 1. diet + PA counseling 2. usual care | Usual care: Primiparas are recommended 11-15 visits to a public health nurse and 3 to a physician during pregnancy. Intervention: Individual counseling on diet + PA and IOM guidelines for GWG, during 5 routine visits to a public health nurse from wk 8-9 to wk 37 of gestation. Option to attend supervised group exercise. | Randomization: D Allocation: B Blinding: B Losses: C | high |
Phelan, 2011 [24] | USA | RCT | n = 358 Non-smoking pregnant women, BMI 19,8-40 | wk 10-16 of gestation | 1. diet + PA counseling 2. usual care | Intervention: Standard care + 1 visit to interventionist promoting self monitoring including; appropriate weight gain, PA (30 min/day) and diet (20 kcal/kg). Participants also received 3 phone calls from a dietitian + weekly mail. | Randomization: A Allocation: A Blinding: A Losses: A | low |
Polley, 2002 [25] | USA | RCT | n = 110 Normal weight pregnant women, BMI 19,8-26 Overweight pregnant women, BMI > 26 | < 20 wk of gestation | 1. diet + PA counseling 2. usual care | Intervention: Regularly antenatal visits with access to research dietician and psychologist. Newsletters and phone calls between clinical visits, with education and feedback relating to weight gain, exercise and healthy eating. | Randomization: A Allocation: B Blinding: B Losses: A | Moderate |
Thornton, 2009 [26] | USA | RCT | n = 232 Obese pregnant women, BMI ≥ 30 | wk 12-28 of gestation | 1. caloric restriction 2. usual care | Intervention: Placed on an 18-24 kcal/kg diet consisting of 40% CH, 30% protein, and 30% fat after a visit to a dietitian. The women were asked to record in a diary all of the foods and beverages consumed during each day. | Randomization: A Allocation: A Blinding: B Losses: A | moderate |
Wolf, 2008 [27] | Denmark | RCT | n = 50 Caucasian obese pregnant women, BMI ≥ 30 | wk 15-18 of gestation | 1. caloric restriction 2. usual care | Intervention: Restriction of GWG to 6-7 kg by 10 1-hour dietary consultations with a trained dietitian, at each antenatal visit. Individual recommendation on daily energy intake, coming from 50-55% CH, 15-20% protein and max 30% fat, according to the official Danish dietary recommendations. 7 day weighed food records were used and individualized suggestions of improvement, were given to those with an identified unhealthy eating pattern. | Randomization: A Allocation: B Blinding: A Losses: C | high |