Evidence map›Paper›PMID 40775715›Full record

SynthesisNutrition journal2025

Energy intake and physical activity over the course of pregnancy and gestational weight gain: a systematic review and dose-response meta-analysis of data from randomized controlled lifestyle intervention trials.

Yixin Chen, Sasithorn Sarnthiyakul, Sophie K F Michel, Chuyue Wu, Hans Hauner, Ondine S von Ehrenstein, Jihong Liu, Liwei Chen

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Nutrition journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yixin Chen *Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Sasithorn Sarnthiyakul *Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Sophie K F MichelDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Chuyue WuDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Hans HaunerInstitute of Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Ondine S von EhrensteinDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Jihong LiuEpidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Liwei ChenDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. cliwei86@ucla.edu.

Funding

UCLA CANCER EPIDEMIOLOGY TRAINING PROGRAMT32CA009142 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ZHANG, ZUO-FENG · 1986 to 2024
$6.3M
Promoting Healthy Weight in Pregnancy and Postpartum among Overweight/Obese WomenR01HD078407 · NICHD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI LIU, JIHONG, WILCOX, SARA · 2014 to 2019
$3.0M
National Cancer Institute, Department of Health and Human Services T32CA009142NCI NIH HHS T32 CA009142NICHD NIH HHS R01 HD078407
6 · The paper itself

Abstract

backgroundThis systematic review and meta-analysis aimed to quantify the relationship between energy intake (EI) and physical activity (PA) during pregnancy and gestational weight gain (GWG) in randomized controlled trials (RCTs).

methodsRCTs measuring EI and PA at least twice and total GWG during pregnancy were eligible. To synthesize PA measures reported on different scales, standardized mean change per day (SMC/day) were obtained by dividing the change in PA by the standard deviation of the change. We estimated mean changes in EI, PA, and mean total GWG across studies, accounting for clustering within studies. One-stage dose-response meta-analyses (DRMA) quantified the additional GWG associated with changes in EI and PA during pregnancy.

resultsA total of 21 RCTs with 7,705 participants were included. The mean total GWG was 11.99 kg (95% CI: 11.05 kg to 12.94 kg). The mean baseline EI was 1977 kcal/day across studies (range: 1652 to 2777 kcal/day) and the mean increase in EI throughout pregnancy was 132 kcal/day (95% CI: 54 to 209 kcal/day). The average change in PA during pregnancy was - 0.11 SMC/day (95% CI: -0.33 to 0.12 SMC/day). DRMA indicated 0.30 kg additional weight gain per 100 kcal/day increase in EI (95% CI: -0.01 kg to 0.60 kg, P = 0.06). The effect size was greater in studies with low risk of bias vs. high risk of bias (0.57 vs. -0.20 kg, P for difference = 0.02). DRMA showed 0.24 kg less weight gain per 0.25 SMC/day increase in PA (-0.50 to 0.02 kg, P = 0.07).

conclusionsAverage GWG often exceeds recommendations of current guidelines, particularly among women with overweight/obesity (OWOB), while average increases in EI were below current recommendations, and PA levels were frequently observed to decrease. DRMA further suggests that GWG may be modifiable through changes in EI and PA with greater EI increases or PA reductions linked to greater GWG, especially among women with OW/OB. Despite challenges in precisely quantifying these associations, integrated findings from this comprehensive systematic review and subgroup/sensitivity analyses highlight the need for more individualized nutrition and exercise recommendations and may warrant revisiting current guidelines.

Indexed as

Energy IntakeExerciseGestational Weight GainLife StyleFemaleHumansPregnancyRandomized Controlled Trials as TopicDose-response meta-analysisEnergy intakeGestational weight gainSystematic review

Identifiers

PMID40775715
PMCPMC12333096

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.