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Rönnberg, Ann-Kristin
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Publications (6 of 6) Show all publications
Rönnberg, A.-K., Hanson, U. & Nilsson, K. (2017). Effects of an antenatal lifestyle intervention on offspring obesity: a 5-year follow-up of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 96(9), 1093-1099
Open this publication in new window or tab >>Effects of an antenatal lifestyle intervention on offspring obesity: a 5-year follow-up of a randomized controlled trial
2017 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 96, no 9, p. 1093-1099Article in journal (Refereed) Published
Abstract [en]

Introduction: Strategies to limit excessive maternal gestational weight gain could also have positive health effects for the offspring. This study informs us on the effect of an antenatal lifestyle intervention on offspring body mass index (BMI) trajectory until age five.

Material and methods: A secondary analysis of a randomized controlled trial aimed at reducing gestational weight gain, set in Orebro, Sweden (Clinical Trials.gov Id NCT00451425). Offspring were followed with standardized measures of weight and height until age five. Mean BMI z-score and proportion (%) of over- and undernutrition (BMI z-score > 2 standard deviations) was compared between groups. Risk estimates for obesity at age five were analyzed in relation to maternal gestational weight gain and prepregnancy BMI as a secondary outcome.

Results: We analyzed 374 children at birth and 300 at age five. No significant difference in mean BMI z-score was seen at birth (0.68 (I) vs 0.56 (C), p = 0.242) or at age five (0.34 (I) vs 0.26 (C), p = 0.510) and no significant difference in proportion of over- or undernutrition was seen. Excessive maternal gestational weight gain was an independent risk factor for offspring obesity at birth (OR = 4.51, p < 0.001) but not at age five. Maternal obesity was an independent risk factor for offspring obesity at age five (OR = 4.81, p = 0.006).

Conclusions: Our composite antenatal lifestyle intervention did not significantly reduce the risk of obesity in offspring up until age five.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Exercise, midwifery, obesity, pregnancy, prenatal care
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-60594 (URN)10.1111/aogs.13168 (DOI)000407745700009 ()2-s2.0-85020964495 (Scopus ID)
Note

Funding Agency:

Research Committee at Örebro County Council

Available from: 2017-09-05 Created: 2017-09-05 Last updated: 2018-08-05Bibliographically approved
Rönnberg, A., Hanson, U., Östlund, I. & Nilsson, K. (2016). Effects on postpartum weight retention after antenatal lifestyle intervention: a secondary analysis of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 95(9), 999-1007
Open this publication in new window or tab >>Effects on postpartum weight retention after antenatal lifestyle intervention: a secondary analysis of a randomized controlled trial
2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 9, p. 999-1007Article in journal (Refereed) Published
Abstract [en]

Introduction: High weight retention after pregnancy is related to an increased risk of future obesity. The objective was to evaluate if an antenatal intervention, compared to standard care, could reduce postpartum weight retention (PPWR).

Material and methods: Women with body mass index >19, age ≥18 years, knowledge of Swedish, and pregnancy ≤16 weeks' gestation were randomized. Standard care was compared to a composite intervention including a personalized weight graph, education on recommended weight gain, prescription of exercise, and monitoring of weight until one year after delivery. Mean (kg) PPWR was compared between the groups and risk estimates (odds ratio) for excessive weight retention were calculated.

Results: Of 445 women randomized, 267 remained for analysis at ≤16 weeks postpartum and 168 at one year postpartum. The intervention group had a significantly lower mean PPWR at ≤16 weeks (1.81 kg (standard deviation, SD, 4.52) vs. 3.19 kg (SD 4.77), p=0.016). At one year postpartum, mean retention was still 0.7 kg lower in the intervention group (0.30 kg (SD 5.52) vs. 1.00 kg (SD 5.46)), the difference was not statistically significant (p=0.414). Gestational weight gain above Institute of Medicine recommendations was a significant risk factor for excessive weight retention (>5 kg) one year after delivery (OR 2.44; 95% CI; 1.08-5.52, p=0.029).

Conclusions: A composite lifestyle intervention during pregnancy reduced short-term weight retention, but the effect of the intervention did not remain at one year postpartum. A gestational weight gain above Institute of Medicine recommendations increases the risk of excessive long-term weight retention.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Prenatal care, obesity, women´s health issues, pregnancy
National Category
Obstetrics, Gynecology and Reproductive Medicine Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-49940 (URN)10.1111/aogs.12910 (DOI)000386782100007 ()27100375 (PubMedID)2-s2.0-84982221108 (Scopus ID)
Note

Funding Agency:

Research Committee at Orebro County Council

Available from: 2016-04-26 Created: 2016-04-26 Last updated: 2018-07-10Bibliographically approved
Rönnberg, A.-K. (2016). Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention. (Doctoral dissertation). Örebro: Örebro university
Open this publication in new window or tab >>Gestational Weight Gain: Implications of an Antenatal Lifestyle Intervention
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Excessive gestational weight gain (GWG) is common in developed countries and is associated with an increased risk of maternal and offspring morbidity. Evidence regarding efficacy and safety of antenatal lifestyle intervention is limited in terms of both systematic reviews and original trials. This thesis is based on the need to further explore this research area. Objectives: To assess and grade current evidence and evaluate short and long-term effects of an antenatal lifestyle intervention on women and their offspring Materials: Controlled trials of intervention publishedbefore August 2009 were systematically searched and reviewed. A randomized controlled trial (RCT) including 445 healthy women aged >18 years with a body mass index (BMI) ≥19 and ≤16 weeks pregnant and their offspring was performed during 2007-2015 in Örebro Region, Sweden. Methods: The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used for review. Our RCT (called the VIGA trial) compared standard care with a composite intervention consisting of education, application of a personalized weight graph, prescription of exercise and more frequent monitoring of weight. Standardized measures of weight and height in offspring waere analysed based on World Health Organization (WHO) Child Growth Standards. Results: Quality of evidence across the studies published pre-August 2009 was concluded to be very low. Our intervention significantly reduced mean GWG (kg) but the proportion of women with excessive GWG, according to recommendations, was not significantly reduced. Short- term postpartum weight retention (PPWR) was significantly lower after the intervention but no significant difference remained 1 year after delivery. Offspring mean BMI z-scores or proportion of obesity did not differ between study groups at either birth or age 5. Conclusions: The antenatal lifestyle intervention reduced mean GWG and short-term PPWR but no long-term effects on maternal weight retention or offspring obesity were seen. Alternative modes and timing of intervention should be considered in future research. Reducing the prevalence of pre-conception obesity must still be considered the primary means to improve maternal and fetal outcome.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. p. 61
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 146
Keywords
gestational weight gain, maternal health, pregnancy, prevention of obesity, lifestyle intervention, childhood obesity
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-51439 (URN)978-91-7529-148-2 (ISBN)
Public defence
2016-09-30, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-07-25 Created: 2016-07-25 Last updated: 2017-10-17Bibliographically approved
Rönnberg, A., Östlund, I., Fadl, H., Gottvall, T. & Nilsson, K. (2015). Intervention during pregnancy to reduce excessive gestational weight gain: a randomised controlled trial. British Journal of Obstetrics and Gynecology, 122(4), 537-544
Open this publication in new window or tab >>Intervention during pregnancy to reduce excessive gestational weight gain: a randomised controlled trial
Show others...
2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 4, p. 537-544Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate if a feasible, low-cost intervention could decrease the percentage of women gaining weight above the Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) compared with standard maternity care.

Design: A randomised controlled interventional design.

Setting: Antenatal clinics (n=14) in orebro county, Sweden, participated.

Population: Healthy women with a body mass index (BMI) 19kg/m(2), age 18years and adequate knowledge of Swedish language who signed in for maternity care at 16weeks of gestation.

Methods: Standard care was compared with a composite intervention consisting of education on recommended GWG according to IOM, application of personalised weight graph, formalised prescription of exercise and regular monitoring of GWG at every antenatal visit.

Outcome: The proportion of women gaining weight above IOM guidelines (1990) and mean GWG (kg) was compared between groups.

Results: In all, 445 women were randomised and 374 women remained for analysis after delivery. A majority of the women analysed were normal weight (72%). The intervention reduced the proportion of women who exceeded the IOM guidelines (41.1% versus 50.0%). The reduction was, however, not statistically significant (P=0.086). Mean GWG was significantly lower among women receiving the intervention, 14.2kg (SD 4.4) versus 15.3kg (SD 5.4) in the standard care group (P=0.029).

Conclusions: The low-cost intervention programme tested did significantly reduce the mean GWG but the proportion of women who exceeded the IOM recommendations for GWG was not significantly lower. ClinicalTrials.gov Id NCT00451425

Keywords
Gestational weight gain, maternal health, pregnancy, prevention of obesity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-44110 (URN)10.1111/1471-0528.13131 (DOI)000350139300022 ()25367823 (PubMedID)2-s2.0-84923328050 (Scopus ID)
Note

Funding Agency:

Research Committee at Orebro County Council

Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2018-06-27Bibliographically approved
Rönnberg, A.-K. & Nilsson, K. (2010). Interventions during pregnancy to reduce excessive gestational weight gain: a systematic review assessing current clinical evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. British Journal of Obstetrics and Gynecology, 117(11), 1327-1334
Open this publication in new window or tab >>Interventions during pregnancy to reduce excessive gestational weight gain: a systematic review assessing current clinical evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system
2010 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 117, no 11, p. 1327-1334Article in journal (Refereed) Published
Abstract [en]

Background Excessive weight gain during pregnancy is common in developed countries and increases the risk of complications during pregnancy, delivery and the postpartum period, which can affect both maternal and fetal outcome. Interventions to reduce excessive gestational weight gain have previously not been systematically evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Objectives To determine whether published trials of interventions to reduce excessive gestational weight gain are of sufficient quality and provide sufficient data to enable evidence-based recommendations to be developed for clinical practice in antenatal care. Search strategy A literature search was conducted in the scientific databases PubMed, Cochrane Library, Cinhal and Pedro, and the reference lists of relevant articles were reviewed. The literature search was concluded on 15 August 2009. Selection criteria All randomised controlled trials (RCTs) were considered for inclusion. As the number of published RCTs was limited, we also considered for inclusion all nonrandomised intervention studies that included a control group. Systematic reviews were examined to identify additional original studies. Data collection and analysis Two reviewers independently assessed the quality of the methods and results of all included articles. Extracted data were classified using the GRADE system. Main results Four intervention studies with a randomised controlled design and four intervention trials with a nonrandomised controlled design met the inclusion criteria. As a consequence of important limitations in study design, inconsistency and lack of directness, the overall quality of evidence was judged to be very low using the GRADE system. Authors' conclusions The results of published intervention trials are of insufficient quality to enable evidence-based recommendations to be developed for clinical practice in antenatal care.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-18903 (URN)10.1111/j.1471-0528.2010.02619.x (DOI)000281635900004 ()20840691 (PubMedID)2-s2.0-77956542667 (Scopus ID)
Available from: 2011-10-04 Created: 2011-09-30 Last updated: 2018-02-05Bibliographically approved
Rönnberg, A.-K., Hanson, U. & Nilsson, K.Effects of antenatal lifestyle intervention on offspring obesity: a five year follow-up of a randomized controlled trial.
Open this publication in new window or tab >>Effects of antenatal lifestyle intervention on offspring obesity: a five year follow-up of a randomized controlled trial
(English)Manuscript (preprint) (Other academic)
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-51911 (URN)
Available from: 2016-09-02 Created: 2016-08-31 Last updated: 2017-10-17Bibliographically approved
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