An eHealth Intervention in Pregnancy on Maternal Body Composition and Subsequent Perinatal Outcomes: A Randomized Trial

OBJECTIVE: To examine the effects of a pragmatic multicomponent eHealth intervention in pregnancy on body composition changes and subsequent associations with perinatal outcomes. METHODS: Pregnant individuals (n = 351) enrolled in Louisiana's Women, Infants, and Children program were randomly assigned to a multicomponent eHealth Intervention or Usual Care. Fat percentage, fat mass, and fat-free mass were assessed using bioelectrical impedance at trimester-specific study visits. Mixed models evaluated within- and between-group differences in body composition from early to late pregnancy: overall, by BMI, and by gestational weight gain (GWG) guideline attainment. Effects of body composition changes on perinatal outcomes was evaluated. RESULTS: Compared to Usual Care (n = 172), the Intervention Group (n = 179) had attenuated gains in fat mass, fat mass index, and fat percentage from early to late pregnancy overall, in individuals who had normal weight at enrollment, and in those who exceeded GWG guidelines (p < 0.05). No significant between-group differences in fat-free mass were observed. Fat mass change interacted with intervention effects on neonatal health outcomes (p = 0.01). CONCLUSIONS: Lifestyle interventions during pregnancy may attenuate gestational fat mass gain, particularly among women with normal weight and those who exceed GWG guidelines, with potential implications for neonatal health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04028843.