1397-P: A Pregnancy Lifestyle Intervention Improves Metabolic Profile of Women and Infants by Reducing Gestational Weight Gain (GWG): The GLOW Randomized Controlled Trial

Among pregnant women with overweight or obesity, intensive interventions have reduced GWG but had only small effects on metabolic profile. In the Gestational weight gain and Optimal Wellness (GLOW) randomized controlled trial, we randomized pregnant women with overweight or obesity to a lifestyle intervention (n=199) or standard care (n=195) to evaluate the intervention’s efficacy in reducing GWG and improving metabolic biomarkers during pregnancy and in cord blood. Women in the intervention, vs. those in standard care, had significantly lower weekly rate of GWG from 10 to 32 weeks’ gestation (mean [SD], mean condition difference [95% CI]: 0.31 [0.18] vs. 0.42 [0.16], -0.11 [-0.15 to -0.08] kg/week) and lower total GWG (10.2 [5.6] vs. 12.4 [5.3], -2.2 [-3.3 to -1.1] kg). The intervention significantly reduced women’s fasting insulin, HOMA-IR and leptin from 10 to 32 weeks’ gestation and cord blood C-peptide, and yielded a borderline significant reduction of cord blood leptin (Table). The intervention’s effect on each biomarker was partially mediated by GWG, with the proportion of mediation effects ranging from 50 to 90% (all p-values <.02). Reducing GWG via lifestyle intervention resulted in improved metabolic profile of women and their infants.