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Feasibility of conducting an early pregnancy diet and lifestyle e-health intervention: the Pregnancy Lifestyle Activity Nutrition (PLAN) project

Published online by Cambridge University Press:  08 August 2019

Rae-Chi Huang*
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Desiree Silva
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
Lawrie Beilin
Medical School, The University of Western Australia, Crawley, Western Australia, Australia
Cliff Neppe
Joondalup Health Campus, Shenton Ave, Joondalup, Western Australia, Australia
Katherine E. Mackie
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Emma Roffey
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Lisa Y. Gibson
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Nina D’Vaz
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia
Hayley Christian
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
Christopher M. Reid
School of Public Health, Curtin University, Perth, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Susan L. Prescott
Telethon Kids Institute, Hospital Avenue, Nedlands, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
Address for correspondence: Rae-Chi Huang, The ORIGINS Project, Telethon Kids Institute, Nedlands, Western Australia, Australia. Email:



Childhood obesity is a global issue. Excessive weight gain in early pregnancy is independently associated with obesity in the next generation. Given the uptake of e-health, our primary aim was to pilot the feasibility of an e-health intervention, starting in the first trimester, to promote healthy lifestyle and prevent excess weight gain in early pregnancy. Methods: Women were recruited between 8 and 11 weeks gestation and randomised to the intervention or routine antenatal care. The intervention involved an e-health program providing diet, physical activity and well-being advice over 12 weeks.


Women (n = 57, 43.9% overweight/obese) were recruited at 9.38 ± 1.12 (control) and 9.06 ± 1.29 (intervention) weeks’ gestation, mainly from obstetric private practices (81.2%). Retention was 73.7% for the 12-week intervention, 64.9% at birth and 55.8% at 3 months after birth.

No difference in gestational weight gain or birth size was detected. Overall treatment effect showed a mean increase in score ranking the perceived confidence of dietary change (1.2 ± 0.46, p = 0.009) and score ranking readiness to exercise (1.21 ± 0.51, p = 0.016) over the intervention. At 3 months, infants weighed less in the intervention group (5405 versus 6193 g, p = 0.008) and had a lower ponderal index (25.5 ± 3.0 versus 28.8 ± 4.0 kg/m3) compared with the control group.

Conclusion and Discussion:

A lifestyle intervention starting in the first-trimester pregnancy utilising e-health mode of delivery is feasible. Future studies need strategies to target recruitment of participants of lower socio-economic status and ensure maximal blinding. Larger trials (using technology and focused on early pregnancy) are needed to confirm if decreased infant adiposity is maintained.

Original Article
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

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