Pregnancy, Exercise And nutrition Research study with app support

ISRCTN ISRCTN29316280
DOI https://doi.org/10.1186/ISRCTN29316280
Secondary identifying numbers N/A
Submission date
11/12/2012
Registration date
21/01/2013
Last edited
13/05/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Overweight, body mass index (BMI) ≥ 24.9 kg/m2 and obesity (BMI ≥ 30 kg/m2) carry a huge health burden both on the individual and on society. About 5 out of 10 women of reproductive age are either overweight or obese and this increases the risk of adverse pregnancy and fetal outcomes. For the mother, there is a higher incidence of pre- eclampsia, gestational diabetes and operative intervention at the time of delivery such as caesarean section and instrumental delivery. Problems that can arise in the baby include macrosomia [newborn with an excessive birth weight (baby > 4kg at birth)], shoulder dystocia [occurs when the baby's head has been born but one of the shoulders becomes stuck behind the mother's pelvic bone], birth injury and admission to the special care baby unit. These adverse outcomes correlate with increasing BMI, increasing gestational weight gain, higher maternal blood glucose levels and gestational diabetes. This study will examine the effect of a "healthy lifestyle package with app support" compared with routine pregnancy care on pregnancy outcomes. The "healthy lifestyle package with app support" includes a combination of a healthy diet, an exercise intervention with a smart phone application as an information and motivational source for overweight and obese women in pregnancy. The primary aim is to assess the impact of the "healthy lifestyle package with app support" on development of gestational diabetes when compared to routine antenatal care.

Who can participate?
Women with singleton pregnancies between 10-15 weeks gestation between the ages of 18-45 with a smartphone, and a BMI of greater than 25 kg/m2

What does the study involve?
Women will be randomly assigned into two groups: an intervention group and a control group. Women in the intervention group will have standard antenatal care but will receive a particular ‘healthy lifestyle package with app support’. This package includes a combination of a healthy diet, an exercise intervention with a smart phone application as an information and motivational source for overweight and obese women in pregnancy. The control group will receive a 'regular lifestyle package', which will consist of standard antenatal care and general advice on weight gain according to BMI.

What are the possible benefits and risks of participating?
The benefits for participating are numerous. These include lower glucose levels and less gestational weight gain. The study aims to motivate and change behaviors in order to lead a healthier lifestyle, which will reduce the risk of obstetric and fetal complications as mentioned above and improve long-term health. There will also be an additional scan of the baby to assess growth at 34 weeks. Studies have shown that there are absolutely no risks to the mother or her baby from taking part in a healthy diet and sensible exercise plan during pregnancy.

Where is the study run from?
The study will run from the National Maternity Hospital (Ireland)

When is the study starting and how long is it expected to run for?
The trial is starting in January 2013 and is expected to run for 2 years.

Who is funding the study?
National Maternity Hospital medical fund (Ireland)

Who is the main contact?
Prof. Fionnuala McAuliffe PI
fionnuala.mcauliffe@ucd.ie

Contact information

Prof Fionnuala McAuliffe
Scientific

National Maternity Hospital
Holles St
Dublin
-
Ireland

Phone +353 (0)1 6373216
Email fionnuala.mcauliffe@ucd.ie

Study information

Study designSingle-centre randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titlePregnancy, Exercise And nutrition Research study with app support: A randomized controlled trial
Study acronymPEARs
Study hypothesisThe introduction of a 'healthy lifestyle package with app support’ for overweight and obese women in pregnancy could reduce the incidence of gestational diabetes.
Ethics approval(s)National Maternity Hospital, Holles’ St, Dublin 2, 15/10/2012
ConditionPregnancy/overweight/obesity/gestational diabetes
Intervention1. Recruitment according to above criteria
2. Written and informed consent
3. Randomization will occur into the intervention and control groups.

The intervention group will receive a "Healthy lifestyle package" which consists of targeted advice on a low GI eucaloric diet, individualized exercise goals and a specially designed smartphone application containing daily information about nutrition, and exercise delivered in a motivational way.

The control group will receive usual care or "regular lifestyle group".

At randomization:
1. Maternal anthropometry
2. 3-day food diary, International Physical Activity Questionnaire (IPAQ) and stages of change questionnaire
3. Fasting glucose
4. Intervention group- individual and group education sessions on the healthy lifestyle package as outlined above
5. Control group will receive routine antenatal care which does not include specific nutritional advice nor specific advice on gestational weight gain 24 weeks
6. Research team to be in contact with the intervention group every 2 weeks to support adherence to exercise goals and low GI diet.

28 weeks:
1. Maternal weight recorded
2. Glucose Tolerance Test (GTT)
3. IPAQ, stages of change questionnaire
4. 3 day food diary

34 weeks:
1. Maternal weight recorded
2. Ultrasound for fetal growth
3. 3 day food diary, compliance questionnaire, IPAQ, stages of change questionnaire

Delivery:
1. Cord bloods for glucose
2. Birthweight, Ponderal Index (PI)
Intervention typeOther
Primary outcome measureincidence of gestational diabetes according to the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) criteria at 29 weeks
Secondary outcome measures1. Gestational weight gain
2. Maternal Glycemic Index (GI) value
3. Maternal activity levels in the 3rd trimester
Overall study start date07/01/2013
Overall study end date30/08/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants500 pregnant women in total with a BMI > 25, 250 in intervention arm and 250 in control arm
Participant inclusion criteria1. Singleton pregnancies with a live fetus
2. Smartphone
3. Women between the ages of 18 and 45 at 10-15 weeks gestation with an early pregnancy body mass index (BMI) ≥ 25 kg/m2
4. Women with adequate understanding of the English language and an understanding of the study to enable them to give informed consent to participate
Participant exclusion criteria1. Multiple Pregnancy
2. Women < 18 or >45 years of age
3. Those with pre gestational diabetes or early onset gestational diabetes mellitus or past history of gestational diabetes
4. Fetal anomaly
5. Previous stillbirth/perinatal death
6. Those whose English is inadequate or those who are unable to understand the study adequately to participate
7. Those with a medical disorder requiring medication
Recruitment start date01/03/2013
Recruitment end date30/01/2016

Locations

Countries of recruitment

  • Ireland

Study participating centre

National Maternity Hospital
Dublin
-
Ireland

Sponsor information

National Maternity Hospital (Ireland)
Hospital/treatment centre

Holles St
Dublin
-
Ireland

Phone +353 (0)1 6373216
Email fionnuala.mcauliffe@ucd.ie
Website http://www.nmh.ie
ROR logo "ROR" https://ror.org/03jcxa214

Funders

Funder type

Hospital/treatment centre

National Maternity Hospital (Ireland) - Medical Fund

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2018 Yes No
Results article secondary analysis results 12/05/2021 13/05/2021 Yes No

Editorial Notes

13/05/2021: Publication reference added.
11/04/2018: Publication reference added.
07/12/2016: The overall trial end date has been updated from the anticipated end date of 30/01/2016 to actual end of date of 30/08/2016 and the anticipated start date of 07/01/2013 has been updated to actual recruitment start date of 01/03/2013.