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Maternal-Offspring Metabolics:Family Intervention Trial (MOMFIT)

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ClinicalTrials.gov Identifier: NCT01631747
Recruitment Status : Completed
First Posted : June 29, 2012
Results First Posted : September 25, 2018
Last Update Posted : November 6, 2018
Sponsor:
Collaborators:
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Linda Van Horn, Northwestern University

Study Description
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Brief Summary:
The prevalence of maternal overweight and obesity has nearly doubled in the United States since 1976. In 2004-2005, 42% of pregnant women had body mass index (BMI) above 25 versus 23% in 1993. Most American women are overweight/ obese (OW/OB) at conception, especially within certain racial, ethnic, and lower socioeconomic groups leading to increased adverse maternal and birth outcomes. This study will recruit, randomize and test in 300 ethnically diverse OW/OB pregnant women a behavioral intervention aimed at controlling gestational weight gain (GWG) through recommended diet, activity and lifestyle changes that are to be maintained postpartum. Outcomes include anthropometric (height, weight, percent body fat) metabolic (blood pressure, fasting glucose, insulin, HbA1c, lipids and C-reactive protein) and behavioral measures (diet. physical activity, sleep and stress). In addition, babies will be measured for length, weight and percent body fat. The goal is to limit excessive gestational weight gain through improved maternal lifestyle that can be maintained and modelled for the family post partum and beyond.

Condition or disease Intervention/treatment Phase
Pregnancy Weight Gain Behavioral: Lifestyle Intervention Group Behavioral: Usual Care Group Not Applicable

Detailed Description:
A Randomized Control Trial is planned among ethnically diverse OW/OB pregnant women ages 18-45 years to be randomly assigned to the MOMFIT Active Intervention Group (AIG) or the Educational Control Group (ECG) plus standard obstetrical care. The Dietary Approaches to Stop Hypertension (DASH) diet, along with moderate physical activity and group intervention as utilized in the Diabetes Prevention Program (DPP), will be adapted for pregnant and postpartum women through individual visits to tailor calorie/nutrient/activity goals, plus group coaching sessions and electronic self-monitoring behavior. Evidence based motivational interviewing and state of the art self-monitoring tools involving the LoseIt app will be adapted for pregnant/postpartum women via smartphone or Internet access, along with tailored feedback and encouragement from the Lifestyle Coach. Prevention of excessive GWG and achievement of the Institute Of Medicine (IOM) weight gain goals will be compared between groups, whether ongoing adherence to the lifestyle interventions can be sustained through postpartum intervention. Approximately one third of the participants are expected to be minorities and/or from low income backgrounds. The primary outcome is gestational weight gain from baseline (self-reported prepregnancy weight) to near delivery (36 weeks) compared with IOM goals in both groups and postpartum weight retention between 6 weeks and 12 months postpartum. Additional outcome variables include changes in maternal Body Mass Index (BMI) and adiposity postpartum, blood pressure, blood glucose, insulin, Hemoglobin A1c (HbA1c), C-reactive Protein (CRP), and lipids, diet quality, and physical activity levels, offspring adiposity and anthropometrics, and glucose and C-peptide in cord blood
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 281 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Maternal-Offspring Metabolics:Family Intervention Trial (MOMFIT)
Study Start Date : November 2012
Actual Primary Completion Date : July 31, 2017
Actual Study Completion Date : July 31, 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Body Weight

Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Usual Care Group
Mom and family continue their typical eating, activity and other lifestyle habits for 24 months. They are invited to attend quarterly classes addressing prenatal wellness and family topics.
 Behavioral: Usual Care Group
Mom and family continue their typical eating, activity and other lifestyle habits for 24 months. They are invited to attend quarterly classes addressing prenatal wellness and family topics.
Experimental: Lifestyle Intervention Group
Women in the Intervention group will participate in a lifestyle program based on Moms'adopting a healthier diet and becoming more active for 24 months. Implementation is at approximately 15 weeks.Moms will meet individually with their Lifestyle Coach (LC)at least 3 times(more as needed, attend six sessions during pregnancy and one session after delivery. In addition moms will participate in monthly phone counseling sessions with Lifestyle Coach and complete daily tracking of diet & activity and use of pedometer
 Behavioral: Lifestyle Intervention Group
Moms will meet individually with their Lifestyle Coach (LC)at least 3 times(more as needed, attend six sessions during pregnancy and one session after delivery. In addition moms will participate in monthly phone counseling sessions with Lifestyle Coach and complete daily tracking of diet & activity and use of pedometer


Outcome Measures
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Primary Outcome Measures :
  1. Gestational Weight Gain (GWG) [ Time Frame: 14-37 weeks ]
    The primary outcome is GWG as assessed continuously by the difference between the maternal weight measured at the baseline and at the 35-37 week visit.


Secondary Outcome Measures :
  1. Percentage of Participants With Gestational Diabetes [ Time Frame: 24-26 weeks ]
    Oral Glucose Tolerance Test (OGTT) will be administered at 24-26wks, as part of routine obstetric visit. Difference in incidence of Gestational diabetes between study groups will be documented.

  2. Fasting Glucose [ Time Frame: 14-37 wks ]
    Blood will be collected at Baseline and 35-37 weeks.

  3. High-density Lipoprotein (HDL) [ Time Frame: 14-37 wks ]
    Blood will be collected at Baseline and 35-37 weeks.

  4. Low-density Lipoprotein (LDL) [ Time Frame: 14-37 weeks ]
    Blood will be collected at Baseline and 35-37 weeks.

  5. Total Cholesterol [ Time Frame: 14-37 Weeks ]
    Blood will be collected at Baseline and 35-37 weeks.

  6. Triglycerides [ Time Frame: 14-37 Weeks ]
    Blood will be collected at Baseline and 35-37 weeks.

  7. Leptin [ Time Frame: 14-37 weeks ]
    Blood will be collected at Baseline and 35-37 weeks.

  8. Steady State Beta Cell Function [ Time Frame: baseline (14 weeks) and 35-37 weeks ]
    Insulin resistance will be measured with the assistance of a computer program (HOMA Calculator v2.2.3, Diabetic Trial Unit, University of Oxford) which uses blood Glucose and Insulin measures to yield the Homeostatic Model Assessment (HOMA) Steady State beta cell function (%B). 100% is set at normal reference. Should not be interpreted alone, but in combination with Insulin Sensitivity (%S).

  9. Insulin Sensitivity [ Time Frame: baseline(14 weeks) and 35-37 weeks ]
    Insulin resistance will be measured with the assistance of a computer program which will yield the Homeostatic Model Assessment (HOMA) Insulin Sensitivity (%S). 100% is equivalent to the normal reference, but needs to be interpreted in context of %B.

  10. Insulin Resistance (IR) [ Time Frame: Baseline (14 weeks) and 35 weeks ]

    Insulin resistance will be measured with the assistance of a computer program (HOMA Calculator v2.2.3, Diabetic Trial Unit, University of Oxford) which uses blood Glucose and Insulin measures to yield the Homeostatic Model Assessment (HOMA) Insulin Resistance. HOMA IR (insulin resistance) is the reciprocal of insulin sensitivity (%S), as a percentage of a normal reference population (100/%S); Lower IR is better.

    Note: estimates are model-derived, and not linear approximations.


  11. Birth Weight [ Time Frame: Delivery ]
    Neonatal Body measurements

  12. Birth Length [ Time Frame: Delivery ]
    Neonate birth measures

  13. Head Circumference [ Time Frame: Delivery ]
    Neonate birth measures

  14. Neonate Percent Body Fat [ Time Frame: Delivery ]
    Neonate percent body fat as measured by PeaPod, and air displacement plethysmography system.

  15. Infant Weight [ Time Frame: 1 year ]
    Infant Body measurements

  16. Infant Length [ Time Frame: 1 year ]
    Infant body measurement


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18-45 years
  • Singleton viable pregnancy. A twin pregnancy reduced to singleton before 14 weeks by project gestational age. An ultrasound must be conducted before randomization that shows a fetal heartbeat; there should be no evidence of more than one fetus on the most recent pre-randomization ultrasound.
  • Gestational age at randomization no earlier than 9 weeks 0 days and no later than 15 weeks 6 days based on an algorithm (see Section 3.4.3 below) that compares the last menstrual period (LMP) date and data from the earliest ultrasound
  • Body mass index between 25-35 kg/m2 based on first trimester measured weight and on measured height. The earliest weight measurement before randomization, measured specifically for the study will be used.

Exclusion Criteria:

  • In vitro fertilization (IVF) conception/ovulation induction w/ gonadotropins
  • Weight gain of >15 pounds from reported prepregnancy weight to Baseline visit
  • Current smoker
  • Prior bariatric surgery
  • In weight loss program w/in 3 months of conception
  • History of alcohol or drug abuse within 5 years
  • No access to internet and/or smartphone
  • Unable to attend intervention/follow-up visits
  • Unwilling/unable to commit to self-monitoring data collection
  • Unable to complete intervention program
  • Presence of any condition that limits walking or following diet recommendations
  • Not fluent in English
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01631747


Locations
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United States, Illinois
Northwestern Memorial Hospital; Prentice Women's
Chicago, Illinois, United States, 60611
Northwestern University: Dept of Preventive Medicine
Chicago, Illinois, United States, 60611
Sponsors and Collaborators
Northwestern University
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Investigators
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Principal Investigator: Linda V Van Horn, PhD Northwestern University
Principal Investigator: Alan Peaceman, MD Northwestern Memorial Hospital
  Study Documents (Full-Text)

Documents provided by Linda Van Horn, Northwestern University:
Study Protocol and Statistical Analysis Plan  [PDF] May 28, 2016

More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Linda Van Horn, Professor, Preventive Medicine, Northwestern University
ClinicalTrials.gov Identifier: NCT01631747    
Other Study ID Numbers: DK10-014
1U01HL114344-01 ( U.S. NIH Grant/Contract )
First Posted: June 29, 2012    Key Record Dates
Results First Posted: September 25, 2018
Last Update Posted: November 6, 2018
Last Verified: October 2018
Keywords provided by Linda Van Horn, Northwestern University:
Pregnancy
Weight gain
Obesity
Pregnancy and weight gain
Additional relevant MeSH terms:
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Weight Gain
Body Weight Changes
Body Weight