Conclusion
metabolic diseases, GDM, Prematurity
METABOLIC DISEASES, GDM, PREMATURITY
Knowledge regarding the importance of the transgenerational impact of metabolic diseases has increased in recent years. This is the first interdisciplinary lifestyle and psychosocial pre- and postpartum intervention in women with GDM that also focused on their offspring. It did not lead to a significant improvement in most birth and neonatal outcomes, offspring anthropometry or psychobehavioral outcomes in the offspring up to one year compared to an active lifestyle guidelines-based usual-care group, but the rates of adverse outcomes were very low in both groups and anthropometric and psychobehavioral outcomes were similar to healthy control populations. Prematurity tended to be lower in the intervention group and length at birth was reduced in the intervention group, although, these between-group difference were only close to reaching statistical significance. Also, the clinical significance of the reduction in length at birth remains to be elucidated. There were few adverse outcomes in both groups and no differences between the intervention and the guidelines-and lifestyle-based usual-care group. Thus, we could conclude that following the current guidelines in mental health and lifestyle recommendations in women with GDM stringently, following up and motivating patients regularly might be sufficient, although this should continue far beyond one year postpartum. A future trial to improve offspring outcomes in mothers with GDM might benefit from an intervention starting early in pregnancy, a stronger focus on the offspring behavior and health, as well as on novel, culturally adapted technologies and should continue far beyond one year postpartum.