LIFE-Moms: effects of multicomponent lifestyle randomized control trial on physical activity during pregnancy in women with overweight and obesity

Hannah E. Cabre, Reproductive Endocrinology and Women's Health Research Program, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA.
Kimberly L. Drews, Reproductive Endocrinology and Women's Health Research Program, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA.
Jeremy Pomeroy, Marshfield Clinic Research Institute, Marshfield, WI, USA.
Sarah Kozey Keadle, Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, CA, USA.
S Sonia Arteaga, ECHO, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
Paul W. Franks, Department of Nutrition, Harvard T.H. Chan Public Health School, Harvard University, Boston, MA, USA.
Debra Haire-Joshu, Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA.
William C. Knowler, Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.
Xavier Pi-Sunyer, Department of Medicine, New York Obesity Research Center, College of Physicians and Surgeons,, Columbia University, New York, NY, USA.
Linda Van Horn, Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Rena R. Wing, Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, CA, USA.
Alison G. Cahill, Department of Women's Health, University of Texas, Austin, TX, USA.
Rebecca G. Clifton, The Biostatistics Center, George Washington University, Washington, DC, USA.
Kimberly A. Couch, Frontier Nursing University, Phoenix, AZ, USA.
Dympna Gallager, Department of Medicine, New York Obesity Research Center, College of Physicians and Surgeons,, Columbia University, New York, NY, USA.
Jami L. Josefson, Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Kaumudi Joshipura, Bagchi School of Public Health, Ahmedabad University, Ahmedabad, India.
Samuel Klein, Center for Human Nutrition, Washington University in St. Louis, St. Louis, MO, USA.
Corby K. Martin, Reproductive Endocrinology and Women's Health Research Program, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA.
Alan M. Peaceman, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Suzanne Phelan, Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, CA, USA.
Elizabeth A. Thom, The Biostatistics Center, George Washington University, Washington, DC, USA.
Leanne M. Redman, Reproductive Endocrinology and Women's Health Research Program, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA. leanne.redman@pbrc.edu.

Document Type

Journal Article

Publication Date

9-30-2025

Journal

The international journal of behavioral nutrition and physical activity

Volume

22

Issue

1

DOI

10.1186/s12966-025-01805-9

Keywords

Clinical trials; Gestational weight gain; Maternal health outcomes; Moderate to vigorous physical activity; Neonatal health outcomes

Abstract

BACKGROUND: This report details the effect of LIFE-Mom's multicomponent lifestyle interventions on physical activity (PA) and inactivity time across pregnancy (2nd and 3rd trimesters) and their effect on gestational weight gain (GWG) and maternal/neonatal outcomes, a pre-specified secondary analysis. METHODS: Pregnant people with BMI ≥ 25 kg/m were randomized to lifestyle interventions with dietary and PA counseling or standard care. PA and inactivity time measured by accelerometry and metabolic and inflammatory biomarkers measured in fasting blood are reported in 522 pregnant people at baseline and end of pregnancy. Generalized linear models with and without covariates were used to evaluate group differences (intervention vs. control) and, separately, time differences (total sample with both groups combined). RESULTS: Although there were statistically significant differences in vigorous activity between the intervention and control group (p = .024), there were no clinically meaningful differences in PA. In the combined sample, moderate to vigorous PA (MVPA) significantly decreased across pregnancy (mean ± SD: 72.9 ± 29.1 min/day vs 63.9 ± 28.1 min/day; p < 0.0001), and inactivity time increased [617.5 min/day (573.5, 659.6) vs 630.4 min/day (56.7, 679.9); p < 0.0001]. Increased inactivity time was associated with a less favorable maternal milieu (biomarker Z-scores) for pro-inflammatory (0.2 ± 0.1; p = 0.003) and cardiometabolic markers (0.1 ± 0.07; p = 0.030). CONCLUSIONS: Physical activity declined over the course of pregnancy, though the intervention group experienced a smaller reduction in activity levels. Our results linked increased inactivity time to maternal metabolic dysregulation and inflammation. Further research is needed to determine if intensive interventions reducing inactivity can improve maternal health and weight outcomes in pregnant people with overweight and obesity. TRIAL REGISTRATION: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, and NCT01812694.

Department

Biostatistics and Bioinformatics

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