P14\u2005Physical activity interventions for overweight and obesity during pregnancy: a systematic review of the content of behaviour change interventions

Abstract

Aim The aim of this study was to identify and summarise the effectiveness of physical activity (PA) interventions on PA levels for pregnant women with overweight and obesity, with a specific emphasis on the behaviour change techniques (BCTs) employed. Methods A systematic review and meta-analysis of PA intervention studies using the PRISMA statement was conducted. Searches were conducted of eight databases in January 2018. Strict inclusion/exclusion criteria were employed. Primary outcome measures included change in PA levels, subjectively or objectively measured with physical fitness as a secondary outcome. The BCT taxonomy V1 was used to identify BCTs. Meta-analyses using random effect models assessed the intervention effects on PA. Other PA outcomes were summarised in a narrative synthesis. Results From 8024 studies, 17 met the inclusion criteria. Of these, 11 studies provided data suitable for inclusion in a meta-analysis. Significant increases were found for metabolic equivalent (SMD 0.38 [0.07, 0.70], Z=2.40 P=0.02) and physical fitness (VO2 max) (SMD 0.55 [0.34, 0.75], Z=5.20 P=<0.001). Six additional studies were narratively described, five of which reported an increase in PA for the intervention group versus the control. ‘Self-monitoring of behaviour’ was the most frequently used BCTs (70.6%), with ‘social support’ unique to this population. Discussion This review revealed a slight increase in PA for pregnant women with overweight and obesity. However, these conclusions are tentative because of the poor methodological quality of the included studies. A range of BCTs clusters that could be used to help improve physical activity levels during pregnancy was identified, including: ‘goals and planning’, ‘feedback and monitoring’ and ‘shaping knowledge’ with ‘social support’ being unique to this population. Future studies should consider PA measures carefully so that studies can be meaningfully compared and intervention developers need to use recognised and standardised taxonomies so that BCTs can be accurately assessed.