Background:Maternal obesity and gestational weight gain are implicated in the development of childhood obesity tracking from neonatal adiposity. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity.

Methods:In the Vitamin D And Lifestyle Intervention (DALI) Lifestyle trial, 436 women with a body mass index ≥ 29 kg/m2 were randomly assigned to counseling on Healthy Eating (HE), Physical Activity (PA), HE&PA, or to usual care (UC). Neonatal outcomes were head, abdominal, arm and leg circumference, skin folds, estimated fat mass, fat percentage, fat free mass, and cord blood leptin. Intervention effects on neonatal outcomes were assessed in multilevel analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed.

Results: Outcomes were available from 334 neonates. A reduction in sum of skin folds (-1.8 mm; 95% CI, −3.5 to -0.2; p=0.03), fat mass (-63 g; 95% CI, -124 to -2; p=0.04), fat percentage (−1.2%; 95% CI -2.4 to -0.04; p=0.04), and cord blood leptin (-3.80 µg/l; 95% CI -7.15 to -0.45; p=0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (-5.79 µg/l; 95% CI, -11.43 to -0.14; p=0.05) compared to UC. Reduced sedentary behavior, but not gestational weight gain, mediated intervention effects on leptin in the HE&PA and PA group.

Conclusion:The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary behavior seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity of the offspring need to be elucidated.


M. van Poppel: None. D. Simmons: Speaker's Bureau; Self; Roche Diabetes Care Health and Digital Solutions, AstraZeneca, Novo Nordisk Inc., Medtronic. G. Desoye: None.

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