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Table 1 Characteristics of included studies

From: Effectiveness of physical activity interventions for overweight and obesity during pregnancy: a systematic review of the content of behaviour change interventions

Author & Year Country Study design N Age BMI Gestation Pregnancy type Other risk factors Intervention detail (brief description, comparison) Type of PA measure PA outcome measure
Callaway et al 2010 [48] Australia Pilot RCT 50 Aged 18–45 BMI ≥ 30 Not specified Not specified Not specified Intervention group: individualized exercise program with an energy expenditure EE goal of 900 kcal/ week Comparison: routine obstetric care Self-report Pregnancy Physical Activity Questionnaire (PPAQ) - MET (hr/week)
Oostdam et al 2012 [54] Amsterdam RCT 101 Not specified BMI ≥ 25 or ≥ 30 Not specified Not specified At least one: macrosomia, history of GDM or relative with T2D Exercise programme consisting of aerobic + strength exercises aimed top control blood glucose levels. Comparison: received normal care from obstetricians and or midwives Objective ActiTrainer accelerometer ActiGraph accelerometer - Total minutes per week of PA + MET cut -off values
Nascimento et al 2011 [53] Brazil RCT 82 Not specified BMI 26–29 14–24 weeks Not specified Not specified Two components: The exercise protocol consisting of light-intensity to moderate-intensity exercises + home exercise counselling. Comparison: no physical activity counselling, received routine prenatal care Self-report Women recorded the type + minutes of exercise in an exercise journal
Kong et al 2014 [50] USA Pilot RCT 37 Aged 18–45 BMI > 25 or > 30 Not specified Singleton Non-smoker, no prior history of chronic disease Unsupervised walking program - Walking (150 min/week of moderate PA during pregnancy). Comparison: no physical activity recommendations, no restrictions from physical activity participation Objective StepWatch Activity Monitor (SAM) accelerometer - using step data (counts)
Seneviratne et al 2016 [64] Auckland New Zealand Two arm parallel RCT 75 Aged 18–40 BMI ≥ 25 < 20 weeks Singleton Not specified Structured home-based exercise programme using magnetic stationary bicycles. Comparison: no intervention or heart rate monitor Objective Heart rate monitor - duration and intensity of cycling
Ong et al 2009 [56] Western Australia RCT 12 Aged 30 (±4 years) BMI ≥ 30 Not specified Singleton Sedentary women, a normal 18 week scan Home-based supervised exercise using an upright stationary cycle ergometer that each participant kept in their home during the intervention. Comparison: continued with their usual daily activities while receiving regular antenatal care Objective and self-report Aerobic Power Index sub maximum test and Pregnancy PA questionnaire
Santos et al 2005 [57] Brazil RCT 72 Aged ≥ 20 BMI ≥ 25 Not specified Not specified Non-smoking Supervised PA consisting of warm up, heart rate monitored activity, upper and lower limbs, stretching and relaxation. Comparison: participated in once weekly sessions that included relaxation (respiratory exercises and light stretching (no aerobic or weight resistance) Participates were neither encouraged nor discouraged to exercise Objective and self-report Physical activity questionnaire) and the Aerobic Power Index sub maximum test- Vo2max
Garnaes et al 2016 [65] Norway Single centre, parallel group RCT 91 Aged ≥ 18 BMI ≥ 28 < 18 weeks Singleton Live fetus at 11–14 week ultrasound scan Supervised exercise consisting of treadmill walking/jogging for 35 min (endurance) and resistance training for large muscle groups and the pelvic floor muscles. Comparison: ordinary maternity care by their midwife, GP and or obstetrician Self-report PA questionnaire - Frequency, duration and intensity of weekly PA
Dodd et al 2014 [60] South Australia Multicentre RCT 1924 Not specified BMI ≥ 25 Between 10 and 20 weeks Singleton Not specified Lifestyle Advice consisted of dietary + lifestyle intervention including dietary, PA and behavioural strategies + goal setting. Comparison: continued pregnancy care according to local hospital guidelines Self-report Health-enhancing PA (SQUASH) - MET (min/week)
Guelinckx et al 2009 [51] Belgium RCT 122 Not specified BMI > 29 < 15 weeks Not specified White Passive group: brochure consisting of diet and PA advice + tips to limit weight gain. Active group: received the same brochure and was actively counselled. Techniques of behavioural modification were used. Comparison: routine perinatal care Self-report Baecke questionnaire - Total score for PA from a minimum of 3 to a maximum of 15
Hawkins et al 2015 [49] Western Massachusetts Pilot RCT 68 Aged 18–40 BMI ≥ 25 < 18 weeks Not specified Hispanic women, participating in < 30 min PA per week Achieve PA guidelines through increasing walking and developing a more active lifestyle. Dietary component: decrease foods high in saturated fat and increase fibre. Comparison: standard care Self-report Pregnancy PA Questionnaire (PPAQ) - average MET (h/week)
aKoivusalo et al 2016 [52] Finland RCT 269 Aged ≥ 18 BMI ≥ 30 < 20 weeks Not specified History of GDM Dietary and PA counselling (minimum of 30 min of moderate intensity exercise and to adopt an overall active lifestyle). Comparison: received general antenatal care, information leaflets provided by the local antenatal clinics. Self-report Food frequency and PA questionnaire - Self report time spent weekly on PA
Poston et al 2015 [61] UK Multicentre RCT 1555 Aged > 16 BMI ≥ 30 Between 15 and 18 weeks (+ 6 days) Singleton Not specified SMART goals, advice on self-monitoring, problem solving. Handbook about the intervention, theory and recommended food and PA. DVD of an exercise regimen. Comparison: routine antenatal appointments at their trial centre in accordance with local practice Self-report PA questionnaire (IPAQ) - MET (min/week)
Renault et al 2014 [62] Copenhagen Prospective RCT 389 Aged > 18 BMI ≥ 30 Between 11 and 14 weeks Singleton Read and speak Danish Two intervention groups: (PA plus D and PA only) individually advised and encouraged to increase PA aiming at a daily step count of 11,000 steps. The diet intervention consisted of contact with an experienced dietician. Comparison: received usual hospital standard regimen for obese pregnant women Objective Pedometer - Daily steps were registered on 7 consecutive days every 4 weeks
Szmeja et al 2014 [66] South Australia Nested RCT 1108 Not specified BMI ≥ 25 Between 10 and 20 weeks Singleton Not specified Lifestyle advice group from (LIMIT) receive DVD or standard materials. Set goals. Received pregnancy book with nutrition + exercise in pregnancy book. Comparison: received the standard written materials and consultations Self-report Metabolic equivalent task units - MET (min/week)
aVinter et al 2011 [55] Denmark RCT 304 Aged 18–40 BMI 30–45 Not specified Not specified Not specified Two components: dietary counselling and PA. The aim was to limit GWG to 5 kg. Energy requirement was estimated and PA (30–60) min daily. Women also had free full time membership in a fitness centre. Comparison: received information about the content and purpose of the study with access to the website but no intervention Objective Aerobic Power Index submaximal aerobic exercise - VO2max
aBruno et al 2017 [63] Italy Prospective RCT 191 Aged > 18 BMI ≥ 25 Not specified Singleton Not specified PA intervention to develop a more active lifestyle (30mins of PA at least 3 times per week). Comparison: control group received a nutritional booklet which was in accordance with the Italian guidelines for diet and PA during pregnancy. All women the control group received antenatal care Objective Pedometer - Assess the number of steps and the duration of PA
aVan Horn et al 2018 [59] USA RCT 281 Aged 18–45 BMI 24–40 < 16 weeks Singleton Fluent in English, smartphone Intervention prescribed calorie goals based on height, pre-conception weight, PA level and energy needs relevant for restricted total GWG. Comparison: usual care received access to MOMFIT website Objective Pedometer or smartphone tracking device and to log their activity, minutes of activity or steps per day
Kennelly et al 2018 [58] Ireland RCT 565 Aged 18–45 BMI > 25–39.9 Between 10 and 15 weeks Not specified Smartphone Healthy lifestyle package, education session on nutrition and PA advice, healthy eating in pregnancy and benefits and safety of PA. Smartphone application reinforced the education and included 3 components; low glycaemic index recipes, exercise advice and nutritional exercise tips. Comparison: control group received standard antenatal care which in Ireland does not consist of any uniform advice Self-report International Physical Activity Questionnaire (IPAQ)
  1. RCT randomised controlled trial, MET metabolic equivalent, VO2 oxygen output, PA physical activity, EE energy expenditure, D dietary, BMI body mass index, IPAQ international physical activity questionnaire, PPAQ pregnancy physical activity questionnaire, GDM gestational diabetes mellitus, T2D type 2 diabetes, GWG gestational weight gain
  2. aSignificant reduction in maternal outcomes such as gestational weight gain and hypertension, and neonatal outcomes such as birth weight