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Effect of a lifestyle intervention during pregnancy—findings from the Finnish gestational diabetes prevention trial (RADIEL)

Journal of Perinatology volume 38, pages 1157–1164 (2018)Cite this article

Subjects

Abstract

Objective

To assess the effect of lifestyle counseling on perinatal outcomes among women at high risk for gestational diabetes.

Study design

A total of 492 women with obesity and/or prior gestational diabetes were allocated to intervention (four sessions of lifestyle counseling, n = 249) or usual care (n = 243) before 20 weeks’ gestation.

Result

Lifestyle indicators, gestational weight gain, or obstetric and perinatal outcomes did not differ between the two groups. An oral glucose tolerance test in the first half of pregnancy was pathological in 37.7% (n = 87/144) of intervention and 36.5% (n = 72/197) of control group women (p = 0.81). The total incidence of gestational diabetes diagnosed in the first or second half of pregnancy was 44.8% (107/239) in the intervention and 48.1% (111/231) in the control group (p = 0.48).

Conclusions

The high prevalence of impaired glucose metabolism was observed already in early pregnancy, which may have contributed to the lack of effect of the intervention.

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Acknowledgements

We acknowledge the contribution of the study nurses Hanna Oksa, Kirsi Arponen, Päivi Saksa, Maaret Ahola, Pirkko Haapanen, Karoliina Himanen, and Eija Kortelainen, dietitians Riitta Kivelä and Johanna Metsälä, as well as the women participating in the study.

Author information

Authors and Affiliations

  1. Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Kristiina Rönö, Miira Marjuska Klemetti, Emilia Huvinen, Aila Tiitinen, Maritta Pöyhönen-Alho & Saila Birgitta Koivusalo

  2. Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Nora Elisabeth Grotenfelt, Jelena Meinilä, Anita Valkama, Hannu Kautiainen & Johan Gunnar Eriksson

  3. Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland

    Miira Marjuska Klemetti & Beata Stach-Lempinen

  4. Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Miira Marjuska Klemetti & Hannele Laivuori

  5. Folkhälsan Research Center, Helsinki, Finland

    Anita Valkama & Johan Gunnar Eriksson

  6. Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland

    Risto Paavo Roine

  7. Kuopio University Hospital, Kuopio, Finland

    Risto Paavo Roine

  8. Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Risto Paavo Roine

  9. Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Sture Andersson

  10. Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, Helsinki, Finland

    Hannele Laivuori

  11. Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland

    Hannele Laivuori

  12. Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland

    Hannele Laivuori

  13. General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland

    Hannu Kautiainen

  14. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland

    Johan Gunnar Eriksson

Authors
  1. Kristiina Rönö
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  2. Nora Elisabeth Grotenfelt
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  15. Saila Birgitta Koivusalo
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Contributions

KR and NEG wrote the first draft of the manuscript, participated in the implementation of the study, the statistical analyses, and interpretation of the results. In addition, KR prepared the database for statistical analyses. SBK initiated the RADIEL study and participated in the design, planning, and implementation of the study in collaboration with MMK, BSL, AT, MPA, SA, and HL. EH, RPR, and JGE participated in the implementation of the study. SBK coordinated the study in Helsinki and BSL in Lappeenranta. AV and JM participated in the implementation and statistical analyses and interpretation of the nutritional aspects of the study. HK supervised the statistical analyses and participated in the interpretation of the results. All authors contributed to the revision of the manuscript and approved the final version. KR has had full access to the data in the study and final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Kristiina Rönö.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The RADIEL study is funded by the Jalmari and Rauha Ahokas Foundation, the Finnish Foundation for Cardiovascular Research, State funding for university-level health research of Helsinki University Hospital, and South Karelia Central Hospital, Samfundet Folkhälsan, the Finnish Diabetes Research Foundation, the State Provincial Office of Southern Finland, The Vyborg Tuberculosis Foundation, and the Social Insurance Institution of Finland. In addition, The Finnish Medical Foundation, the Finnish Diabetes Research Foundation, the Finnish Cultural Foundation, the Juho Vainio Foundation, and the Helsinki University Doctoral School in Health Sciences supported the PhD study of the first author. The Academy of Finland supported JGE (grant No. 129369, 129907, 135072, 129255, and 126775). The research leading to these results has received funding from the European Commission within the 7th Framework Program and EU H2020-PHC-2014-DynaHealth grant no. 633595. None of the funding bodies had any role in the design of the study, collection and analysis of data or decision to publish.

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Rönö, K., Grotenfelt, N.E., Klemetti, M.M. et al. Effect of a lifestyle intervention during pregnancy—findings from the Finnish gestational diabetes prevention trial (RADIEL). J Perinatol 38, 1157–1164 (2018). https://doi.org/10.1038/s41372-018-0178-8

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