Table 3 Strength of evidence for effect of postpartum lifestyle interventions on weight, adiposity, metabolic and biological markers
Outcome | Strength of evidence | Intervention | Conclusions |
|---|---|---|---|
Weight | Low | Nutrition and Exercise | Four good quality RCTs had inconsistent findings. Three of the four fair-to-good quality studies reported greater weight loss in the intervention group compared to standard postpartum care, but the RCTs were short (≤9 months) in duration and had limited generalizability to racial and ethnic minority groups. |
| Â | Low | Exercise only | Results were inconclusive for comparison of exercise-only interventions with standard postpartum care, with low risk for bias, but moderate imprecision and inconsistency in the dire study findings. |
| Â | Insufficient | Nutrition only | Only one RCT for comparison of diet-only with standard postpartum care, with high attrition rates and differential loss to follow-up between treatment groups. |
Adiposity | Low | All interventions | Few studies included adiposity and there is inconsistency in adiposity measures across studies. One comparison showed a reduction in skinfold thickness; two comparisons reported a statistically significant reduction in waist-to-hip ratios, but estimate of effect were imprecise due to small sample sizes. |
Cardio-metabolic | Insufficient | All interventions | One RCT compared lipid and glucose levels between women receiving a nutrition and exercise intervention and historical controls |
Biological markers | Insufficient | All interventions | Only one RCT was included for the outcome of adiponectin. Findings from the intervention group were compared to non-randomized historical controls. |