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Minerva Ginecologica 2018 June;70(3):254-60

DOI: 10.23736/S0026-4784.17.04156-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

An early, customized low-glycemic-index diet prevents adverse pregnancy outcomes in overweight/obese women

Elisabetta PETRELLA, Valeria TAMBORRINO, Lidia DI CERBO, Isabella NERI, Fabio FACCHINETTI

Unit of Obstetrics and Gynecology, Department of Maternal and Child Health, Polyclinic Hospital, University of Modena and Reggio Emilia, Modena, Italy


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BACKGROUND: To determine whether the prescription and follow-up of a behavioral program (customized nutritional advices and a constant physical activity) influences the occurrence of unfavorable maternal/neonatal outcomes among overweight/obese women.
METHODS: A case-control study (1:3) included single pregnant women with Body Mass Index (BMI) ≥25 kg/m2, enrolled at 1st trimester. Cases (N.=95) were prescribed (by both the dietitian and gynecologist) a low-glycemic-index diet with an average intake of 1700/1800 kcal/day plus 30 minutes of walking at least 3 times/week (with four follow-up visits until delivery). Controls (N.=275) received a nutritional booklet about a healthy lifestyle, then attended their scheduled visits until delivery by the obstetricians in charge.
RESULTS: Gestational weight gain was similar between groups, despite obese women were higher in cases (67.4%) than in controls (54.5%, P=0.029). The occurrence of gestational diabetes mellitus (GDM) was lower in cases (21.5%) than in controls (32.7%; P=0.041). Such reduction remained related with the group of intervention (P=0.004) after correcting for confounders (BMI≥30 kg/m2, a family history of diabetes, age ≥35 and ethnicity). A higher number of controls developed pregnancy induced hypertension (PIH) (11.6% vs. 1.1% in cases, P<0.001). Preterm birth (PTB) occurred in one case and in 28 controls (10.2%; P=0.004). In half of them, PTB was spontaneous while medically indicated for intrauterine growth restriction, hemorrhage, PIH, GDM/macrosomia, Rh isoimmunization in the remnant.
CONCLUSIONS: An early behavioral intervention among overweight/obese pregnant women reduces unfavorable pregnancy outcomes.


KEY WORDS: Pregnancy - Obesity - Gestational diabetes - Pregnancy-induced hypertension - Fetal macrosomia - Diet

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