Page 175 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

3.5 Feasibility and effectiveness of a lifestyle intervention| 173
intervention. Lifestyle interventions before or during pregnancy are known to be effective in improving obstetrical outcome283 284. If started shortly after a complicated pregnancy, lifestyle intervention might give a larger reduction of the risk of recurrence in the next pregnancy than starting at a next pregnancy or when a next pregnancy is intended. Further studies are needed to evaluate this hypothesis.
We used weight loss as proving effectiveness of lifestyle intervention. Although used as primary outcome variable to test effectiveness by many other intervention studies, recently the Look AHEAD study showed that during the years after intervention weight was regained285. However, weight remained slightly but significantly lower, even years after the intervention, compared to women who did not have had intervention.
Strengths and weaknesses of the study
A major strength of this study is that it addresses a topic that is frequently being mentioned in preeclampsia research, but has never been studied before.
Another strength of this study is that we used validated questionnaires to evaluate lifestyle habits and tailored them to individual goals in the counselling sessions to make them easily applicable. Finally, we had a high participation rate as compared to other primary lifestyle studies, adding to the generalisability of our results. Although selection bias can never be totally eradicated in primary lifestyle intervention studies, our non-randomized study design and still low participation and adherence rates contributed to this bias.
Some other factors limit generalisability of our results. First we did not have information about the women who declined participation or could not be traced. Whether our results are applicable to these women, is unclear. Second, the majority of the women in the study were Dutch. Whether our results are