Strengths and limitations
GDM
GDM, OBESE
This complex lifestyle and psychosocial intervention focusing on many important factors and intervening both on the mother and the offspring in a relatively large sample is an important strength of this study. The limitations of this study first concern the fact that we had an active lifestyle and guidelines-based usual-care group that also received important advice about maternal lifestyle behaviors and breastfeeding, limiting potential intervention effects. This differs compared to other populations such as healthy control or obese women, as women with GDM are regularly followed up and current recommendations also include postpartum visits. Furthermore, the intervention group may have had too many maternal and infant health goals to be able to implement them. We did not measure adherence to the behavioral goals regarding the offspring, such as timing of introduction of solid foods or objective measures of physical activity (accelerometry), as this would have increased the participant burden. However, the mothers were regularly followed up by the coach who reviewed the adherence with the participants. Moreover, the WHO recommends exclusive breastfeeding for at least 6 months. However, in accordance with the local pediatricians and the usual practice in Switzerland, we based ourselves on European and Swiss guidelines to introduce solid foods after at least 4 months of age. This could be considered as a potential limitation. Unfortunately, we did not formally check if women were still breastfeeding at 6 months. In addition, the psychobehavioral outcomes were solely assessed 