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Follow up after preconception lifestyle RCTs
Would answer question whether preconception lifestyle intervention
- Has lasting effects on maternal health
- Impacts offspring health
Advantages
- Is unbiased by genetics/ social environment
- Allows cost effectiveness to be assessed
using potentially long lasting health benefits
- Could curb transgenerational obesity cycle
Disadvantage
- Cannot disentangle contribution
preconception/ antenatal and postnatal factors
vd Beek et al, BMJ Open, 2017 Wekker et al, submitted 2018
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Conclusion
Animal studies
- are not hampered by postnatal or genetic confounders
- Show that in utero environment is a driving causal force in perpetuating the obesity epidemic
NICE, RCOG and ACOG guidelines recommend preconception/ periconception weight loss
- Randomized evidence of programmes aimed at individual patients show limited effects
- Public health interentions may make a bigger difference
RCOG Guideline, March 2010 NICE Guideline July 2010 ACOG practice Bulletin, 201537
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PresentationAMC.pptx PresentationAMC.pptx