Cardiovascular Journal of Africa: Vol 28 No 6 (November/December 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017 AFRICA 397
Review Article
The effect of lifestyle interventions on maternal body
composition during pregnancy in developing countries:
a systematic review
Estelle D Watson, Shelley Macaulay, Kim Lamont, Philippe J-L Gradidge, Sandra Pretorius, Nigel J
Crowther, Elena Libhaber
Abstract
Optimal maternal body composition during pregnancy is
a public health priority due to its implications on mater-
nal health and infant development. We therefore aimed to
conduct a systematic review of randomised, controlled trials,
and case–control and cohort studies using lifestyle interven-
tions to improve body composition in developing countries.
Of the 1 708 articles that were searched, seven studies, repre-
senting three countries (Brazil, Iran and Argentina), were
included in the review. Two articles suggested that interven-
tion with physical activity during pregnancy may significantly
reduce maternal weight gain, and five studies were scored
as being of poor quality. This systematic review highlights
the lack of research within developing countries on lifestyle
interventions for the management of excessive weight gain
during pregnancy. Similar reviews from developed countries
demonstrate the efficacy of such interventions, which should
be confirmed using well-designed studies with appropriate
intervention methods in resource-limited environments.
Keywords: diet, physical activity, pregnancy, obesity, gestational
weight gain
Submitted 29/9/16, accepted 2/1/17
Published online 24/8/17
Cardiovasc J Afr 2017; 28: 397–403
DOI: 10.5830/CVJA-2017-003
Both developed and developing countries are experiencing a
rapid increase in the prevalence of obesity, which places affected
individuals at an increased risk for a number of different
diseases, including hypertension, diabetes, heart disease, asthma
and cancer.1,2 The World Health Organisation (WHO) estimated
that in 2005 there were approximately 1.6 billion adults (aged 15
years and over) globally who were overweight and at least 400
million adults who were obese.3
Especially alarming is the high prevalence of overweight and
obesity among women of childbearing age in both developed
and developing countries. Around 12 to 38% of pregnant
women in developed countries,5 and 8 to 26% of pregnant
women in developing countries4,6 are reported to be overweight
or obese.
Obesity during pregnancy is associated with an increased risk
for maternal and neonatal complications. The associated adverse
maternal effects of obesity during pregnancy include miscarriage,
pre-eclampsia, gestational diabetes mellitus, infection, venous
thromboembolism and haemorrhage.7 The foetal risks associated
with maternal obesity include stillbirths and neonatal deaths,
preterm births, congenital abnormalities and macrosomia.8
Long-term effects of maternal obesity on the offspring have
also been observed and include increased risks of childhood and
adolescent obesity, and diabetes and cardiovascular disease in
adult life.9
Centre for Exercise Science and Sports Medicine, School
of Therapeutic Sciences, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
Estelle D Watson, PhD,
Philippe J-L Gradidge, PhD, MSc (Med)
MRC/Wits Developmental Pathways of Health Research
Unit, Department of Paediatrics, School of Clinical
Medicine, Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, South Africa
Estelle D Watson, PhD
Shelley Macaulay, MSc (Med) (Human Genetics), MSc (Med)
(Genetic Couselling), BSc (Hons)
Division of Human Genetics, School of Pathology, Faculty
of Health Sciences, University of the Witwatersrand and
the National Health Laboratory Service, Johannesburg,
South Africa
Shelley Macaulay, MSc (Med) (Human Genetics), MSc (Med)
(Genetic Couselling), BSc (Hons)
Soweto Cardiovascular Research Unit, University of the
Witwatersrand, Johannesburg, South Africa
Kim Lamont, PhD, MSc (Med), MPhil (Med) (IP Law)
Sandra Pretorius, PhD
Department of Chemical Pathology, National Heath
Laboratory Service, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South Africa
Nigel J Crowther, PhD
School of Clinical Medicine, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
Elena Libhaber, PhD