Page 73 - PCC05

Systematic Review Preconception Interventions
8 studies included
Most studies were carried out among subfertile women
Greater reduction in weight (-3.5 kg)
Increased natural pregnancy rate (OR 1.87)
No differences in delivery or pregnancy complications, including
• Pregnancy loss; 3 studies OR 1.43 [95% CI:0.89–2.30]
• Preeclampsia; 2 studies OR 0.92 [95% CI: 0.39–2.13]
• Gestational diabetes; 2 studies OR 0.39 [95% CI: 0.05–3.24]
No information about long term health of offspring
Retention of patients can be problematic (21% discontinued in Lifestyle study)
NCT01325805 Study (lifestyle programme for recurrent miscarriage) was terminated early due to lack of recruitment
Lan et al, HR, 2017
34
Randomized controlled trial
Included 577 subfertile women BMI >=29 kg/m2
Assigned to 6 month multifaceted lifestyle intervention or prompt fertility treatment Primary outcome: vaginal birth healthy term singleton within 24 months
3.3 kg more weight loss in intervention group
Primary outcome occurred in 27% in intervention, 35% in control group Improved cardiometabolic outcomes after intervention
blood pressure metabolic syndrome glucose
Unique in the planned follow up study.....
Page 67 of 135
Mutsaerts et al, NEJM, 2016
Van Dammen et al, PLoS One, 2017
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PRECONGRESS COURSE 05 I BARCELONA, SPAIN – 1 JULY 2018 73
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