{"id":"7188603b9ffd","type":"article","url":"https://hartvaat.nl/2021/05/25/gedragsinterventies-voor-gezond-gewicht-in-de-zwangerschap-jama-uspstf-evidence-/","title":"Gedragsinterventies voor gezond gewicht in de zwangerschap: JAMA USPSTF evidence report","title_en":"Counseling and Behavioral Interventions for Healthy Weight and Weight Gain in Pregnancy: Evidence Report and Systematic Review for the US Preventive Services Task Force.","category":"preventie","category_label":"Preventie","professions":["huisarts"],"tags":[],"journal":"JAMA","doi":"10.1001/jama.2021.4230","source_url":"https://doi.org/10.1001/jama.2021.4230","authors":["Amy G Cantor","Rebecca M Jungbauer","Marian McDonagh","Ian Blazina","Nicole E Marshall","Chandler Weeks","Rongwei Fu","Erin S LeBlanc","Roger Chou"],"significance":6,"published":"2021-05-25","source_date":"2021-05-25","image":"","kennis":[],"congress":"","summary_en":"This USPSTF evidence report evaluated counseling and behavioral interventions for healthy gestational weight gain, informing recommendations on lifestyle management during pregnancy for cardiovascular and metabolic health.","created":"2026-07-03T10:29:12Z","updated":"2026-07-03T13:28:20Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"JAMA USPSTF evidence report over gedragsinterventies voor gezond gewicht en gewichtstoename in de zwangerschap.","abstract_original":"IMPORTANCE: Counseling and active behavioral interventions to limit excess gestational weight gain (GWG) during pregnancy may improve health outcomes for women and infants. The 2009 National Academy of Medicine (NAM; formerly the Institute of Medicine) recommendations for healthy GWG vary according to prepregnancy weight category. OBJECTIVE: To review and synthesize the evidence on benefits and harms of behavioral interventions to promote healthy weight gain during pregnancy to inform the US Preventive Services Task Force recommendation. DATA SOURCES: Ovid MEDLINE and the Cochrane Library to March 2020, with surveillance through February 2021. STUDY SELECTION: Randomized clinical trials and nonrandomized controlled intervention studies focused on diet, exercise, and/or behavioral counseling interventions on GWG. DATA EXTRACTION AND SYNTHESIS: Independent data abstraction and study quality rating with dual review. MAIN OUTCOMES AND MEASURES: Gestational weight-related outcomes; maternal and infant morbidity and mortality; harms. RESULTS: Sixty-eight studies (N = 25 789) were included. Sixty-seven studies evaluated interventions during pregnancy, and 1 evaluated an intervention prior to pregnancy. GWG interventions were associated with reductions in risk of gestational diabetes (43 trials, n = 19 752; relative risk [RR], 0.87 [95% CI, 0.79 to 0.95]; absolute risk difference [ARD], -1.6%) and emergency cesarean delivery (14 trials, n = 7520; RR, 0.85 [95% CI, 0.74 to 0.96]; ARD, -2.4%). There was no significant association between GWG interventions and risk of gestational hypertension, cesarean delivery, or preeclampsia. GWG interventions were associated with decreased risk of macrosomia (25 trials, n = 13 990; RR, 0.77 [95% CI, 0.65 to 0.92]; ARD, -1.9%) and large for gestational age (26 trials, n = 13 000; RR, 0.89 [95% CI, 0.80 to 0.99]; ARD, -1.3%) but were not associated with preterm birth. Intervention participants experienced reduced weight gain across all prepregnancy weight categories (55 trials, n = 20 090; pooled mean difference, -1.02 kg [95% CI, -1.30 to -0.75]) and demonstrated lower likelihood of GWG in excess of NAM recommendations (39 trials, n = 14 271; RR, 0.83 [95% CI, 0.77 to 0.89]; ARD, -7.6%). GWG interventions were associated with reduced postpartum weight retention at 12 months (10 trials, n = 3957; mean difference, -0.63 kg [95% CI, -1.44 to -0.01]). Data on harms were limited. CONCLUSIONS AND RELEVANCE: Counseling and active behavioral interventions to limit GWG were associated with decreased risk of gestational diabetes, emergency cesarean delivery, macrosomia, and large for gestational age. GWG interventions were also associated with modest reductions in mean GWG and decreased likelihood of exceeding NAM recommendations for GWG."}