Adherence
Adherence to lifestyle counseling aims (specific dietary changes and physical activity targets) is associated with a significantly lower proportion of LGA newborns and a tendency toward lower GDM incidence compared to usual care.
For pregnant women who can strictly adhere to lifestyle counseling (improving diet and increasing physical activity), the risk of having a large baby is significantly reduced. This suggests that the effectiveness of lifestyle interventions depends heavily on patient adherence.
In subgroup analysis, adherent women in the intervention group (n = 55/229) had decreased risk of GDM (27.3% versus 33.0%, p = 0.43) and LGA newborns (7.3% versus 19.5%, p = 0.03) compared to women in the usual care group.
Why this rating
Subgroup analysis of a well-designed RCT. The sample size for adherent women was smaller (n=55), reducing power for GDM.
Source
Primary Prevention of Gestational Diabetes Mellitus and Large-for-Gestational-Age Newborns by Lifestyle Counseling: A Cluster-Randomized Controlled Trial
Riitta Luoto et al. · PLoS Medicine · 2011
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