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The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women

Obese women are more likely to have decreased insulin sensitivity and are at increased risk for many adverse pregnancy outcomes. An early lifestyle intervention (LI) may have the potential to reduce the impact of insulin resistance (IR) on perinatal outcomes. We report post hoc analysis of an open-l...

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Autores principales: Menichini, Daniela, Petrella, Elisabetta, Dipace, Vincenza, Di Monte, Alessia, Neri, Isabella, Facchinetti, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285042/
https://www.ncbi.nlm.nih.gov/pubmed/32455565
http://dx.doi.org/10.3390/nu12051496
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author Menichini, Daniela
Petrella, Elisabetta
Dipace, Vincenza
Di Monte, Alessia
Neri, Isabella
Facchinetti, Fabio
author_facet Menichini, Daniela
Petrella, Elisabetta
Dipace, Vincenza
Di Monte, Alessia
Neri, Isabella
Facchinetti, Fabio
author_sort Menichini, Daniela
collection PubMed
description Obese women are more likely to have decreased insulin sensitivity and are at increased risk for many adverse pregnancy outcomes. An early lifestyle intervention (LI) may have the potential to reduce the impact of insulin resistance (IR) on perinatal outcomes. We report post hoc analysis of an open-label randomized control trial that includes IR women with body-mass index ≥25 randomly assigned to a LI with a customized low glycemic index diet or to standard care (SC) involving generic counseling about healthy diet and physical activity. Women were evaluated at 16, 20, 28, and 36 weeks of gestation, at which times perinatal outcomes were collected and analyzed. An oral-glucose-tolerance test (OGTT) showed that women in the LI group had lower plasma glucose levels at 120 min at 16–18 weeks of gestation, and at 60 and 120 min at 24–28 weeks. More importantly, these women had a lower rate of large-for-gestational-age (LGA) infants (p = 0.04). Interestingly, the caloric restriction and low-glycemic index diet did not increase the rate of small-for-gestational-age (SGA) babies in the LI group. A lifestyle intervention started early in pregnancy on overweight and obese women had the potential to restore adequate glucose tolerance and mitigate the detrimental role of IR on neonatal outcomes, especially on fetal growth.
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spelling pubmed-72850422020-06-17 The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women Menichini, Daniela Petrella, Elisabetta Dipace, Vincenza Di Monte, Alessia Neri, Isabella Facchinetti, Fabio Nutrients Article Obese women are more likely to have decreased insulin sensitivity and are at increased risk for many adverse pregnancy outcomes. An early lifestyle intervention (LI) may have the potential to reduce the impact of insulin resistance (IR) on perinatal outcomes. We report post hoc analysis of an open-label randomized control trial that includes IR women with body-mass index ≥25 randomly assigned to a LI with a customized low glycemic index diet or to standard care (SC) involving generic counseling about healthy diet and physical activity. Women were evaluated at 16, 20, 28, and 36 weeks of gestation, at which times perinatal outcomes were collected and analyzed. An oral-glucose-tolerance test (OGTT) showed that women in the LI group had lower plasma glucose levels at 120 min at 16–18 weeks of gestation, and at 60 and 120 min at 24–28 weeks. More importantly, these women had a lower rate of large-for-gestational-age (LGA) infants (p = 0.04). Interestingly, the caloric restriction and low-glycemic index diet did not increase the rate of small-for-gestational-age (SGA) babies in the LI group. A lifestyle intervention started early in pregnancy on overweight and obese women had the potential to restore adequate glucose tolerance and mitigate the detrimental role of IR on neonatal outcomes, especially on fetal growth. MDPI 2020-05-21 /pmc/articles/PMC7285042/ /pubmed/32455565 http://dx.doi.org/10.3390/nu12051496 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Menichini, Daniela
Petrella, Elisabetta
Dipace, Vincenza
Di Monte, Alessia
Neri, Isabella
Facchinetti, Fabio
The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title_full The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title_fullStr The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title_full_unstemmed The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title_short The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women
title_sort impact of an early lifestyle intervention on pregnancy outcomes in a cohort of insulin-resistant overweight and obese women
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285042/
https://www.ncbi.nlm.nih.gov/pubmed/32455565
http://dx.doi.org/10.3390/nu12051496
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