Metabolic Health and Heterogenous Outcomes of Prenatal Interventions

Do preexisting metabolic phenotypes of obesity differentially influence the outcomes of a prenatal lifestyle intervention aimed at reducing excess gestational weight gain?This preplanned secondary analysis of 640 participants in a multisite randomized clinical trial showed that pregnant individuals with a metabolically unhealthy obesity phenotype had 36.7% lower gestational weight gain but a higher incidence of gestational diabetes and infants born with greater adiposity compared with pregnant individuals with obesity and a healthier metabolic phenotype in early pregnancy. Participants in both phenotype groups responded similarly to a prenatal lifestyle intervention.Gestational weight gain may be less important than the maternal metabolic milieu in estimating perinatal outcomes and infant health, highlighting the need for prenatal interventions that focus on optimizing maternal metabolic health.

Corresponding Author: Leanne M. Redman, PhD, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808 (leanne.redman@pbrc.edu).

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