Page 156 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

154 | Part 3 Lifestyle intervention ABSTRACT
Objectives To evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease.
Design A specific pre-post controlled design.
Setting One tertiary care hospital and three secondary care hospitals (intervention group); one
secondary care hospital (control group).
Participants Two hundred and six women six months postpartum following a pregnancy
complicated by preeclampsia, FGR or GDM.
Intervention Lifestyle intervention program, consisting of a computer-tailored health education
program in combination with three individual counselling sessions during seven months. Main outcome measures Primary outcome measure of feasibility was the proportion of eligible women who complied with the intervention. Primary outcome measure of effectiveness was
weight change during the intervention.
Results The proportion of eligible women who complied with the intervention was 23%. Major
barrier was lack of time. Adjusted weight change attributed to lifestyle intervention was -1.9 kg (95%-CI -4.3 to -0.3). Further significant changes were observed in BMI (-0.9 kg/m2 (95%-CI -1.4 to -0.3)), waist-to-hip ratio (-0.04 cm/cm (95%-CI -0.06 to -0.03)), blood pressure medication use (19% (95%-CI 9% to 28%)), HOMA2-score (59 %S (95%-CI 18 to 99)) and total fat intake (-2.9 gr (95%-CI -4.6 to -1.2)).
Conclusions The results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. The proportion of eligible women who complied with the intervention was twice as high as in other primary lifestyle intervention studies. Further randomized controlled studies are needed with longer follow-up to confirm our findings and evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.