Table 2 Characteristics of included studies

Dipietro L, Evenson KR, Bloodgood B, et al.

2019 [30]

to summarize the evidence from the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, including new evidence from an updated search of the effects of physical activity on maternal health during pregnancy and postpartum

I. systematic review and meta-analysis

II. Literature review

1. Moderate-intensity physical activity during pregnancy is associated with reduced risk of excessive gestational weight gain.

2. This study emphasizes the public health importance of regular moderate-intensity physical activity before, during, and after pregnancy, and calls for further research in this area.

Withanage NN, Botfield JR, Srinivasan S, et al.

2022 [31]

To evaluate the effectiveness of primary care-based PCC delivered to reproductive-aged females and/or males to improve health knowledge, reduce preconception risk factors, and improve pregnancy outcomes

I. systematic review

II. searched for randomized controlled trials (RCTs)

1. Primary care-based preconception care (PCC) interventions, including brief/intensive education, and dietary modification, effectively improve health knowledge and reduce preconception risk factors; obesity, among females, but more research is needed to confirm their impact on pregnancy outcomes.

2. Preconception care (PCC) education, whether brief or intensive, should be a standard practice for reproductive-aged individuals in primary care.

Most J, Amant MS, Hsia DS, et al.

2019 [32]

to characterize determinants of gestational weight gain in women with obesity

I. prospective, observational study

II. to measure energy intake, energy expenditure, and body composition in 72 pregnant women with obesity

III. energy intake, calculated using the energy intake-balance method, energy expenditure measured by doubly labeled water and calorimetry, and body composition assessed by a 3-compartment model.

1. Women with obesity should gain fat-free mass during pregnancy without increasing fat mass.

2. They should not increase energy intake during pregnancy.

3. Energy imbalance is the main factor in gestational weight gain for women with obesity.

4. A 10% energy deficit is needed to maintain weight during pregnancy.

5. Energy needs should be estimated individually or patients should be advised not to increase energy intake.

6. Lifestyle interventions for weight maintenance in obese pregnant women require a 9% energy deficit.

Goldstein, R.F., Boyle, J.A., Lo, C. et al.

2021 [34]

to describe women’s experiences and perspectives in attending a Healthy Pregnancy Service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity

I. explanatory sequential mixed methods study

II. quantitative questionnaires and qualitative interviews

1. The lifestyle intervention, embedded in routine antenatal care and led by dedicated health professionals, increased women’s confidence and empowered them to make positive changes.

O’Brien EC, Segurado R, Geraghty AA, et l.

2019 [35]

to determine the differential effects of lifestyle interventions (diet based, physical activity based or mixed approach) on GWG, stratified by educational attainment

I. Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs)

1. Diet-based interventions are effective in reducing these risks for lower-educated women.

2. Mixed interventions also help lower-educated women reduce excessive weight gain.

3. Diet-based interventions can mitigate excessive weight gain in higher-educated women.

4. Healthcare professionals should prioritize dietary and mixed interventions for managing gestational weight gain in lower-educated women, as these approaches effectively address both excessive and inadequate weight gain in this group.

Harrison CL, Bahri Khomami M, Enticott J, et al.

2023 [36]

To evaluate intervention components using the Template for Intervention Description and Replication (TIDieR) framework to inform implementation of antenatal lifestyle interventions in routine antenatal care

I. systematic review and meta-analysis

1. Antenatal lifestyle interventions by allied health professionals improved gestational weight gain (GWG).

2. Individual dietary interventions with moderate intensity showed the most significant decrease in GWG.

3. Early and extended physical activity and mixed behavioral interventions were more effective in reducing GWG.

Hart TL, Petersen KS, Kris-Etherton PM.

2022 [37]

To discusses the nutritional recommendations for healthy weight loss before and after pregnancy for women with overweight and obesity

I. Review article

1. Women with overweight or obesity should follow a weight loss diet of 1,200-1,500 kcal/day, aiming for a deficit of 500–750 kcal/day to lose 0.5–1 kg per week.

2. During lactation, women with overweight or obesity can aim for a 500 kcal/day deficit for 6 weeks postpartum, aiming to lose 0.5 kg per week over 4 months, while consuming at least 1,800 calories/day.

Allman-Farinelli M.

2023 [38]

Strengthen the evidence base for weight gain prevention strategies

I. Review article

1. Strategies to prevent weight gain and obesity should target various life stages: pregnancy, early childhood, school-age children, adolescents, and adults.

2. Interventions should integrate dietary adjustments, physical activity promotion, and policy measures targeting the food environment, like regulating food marketing and pricing.

Boyle JA, Dodd J, Gordon A, et al.

2022 [39]

To explore opportunities to change increasing weight gain trajectories for women during their reproductive lives, focusing on optimising health before pregnancy

I. Narrative description of changing policies and approaches for improving preconception health

1. Public awareness about preconception health is lacking, with many women who plan pregnancies not seeking preconception health advice.

2. Strategies are needed to increase public awareness and provide healthcare professionals with proper training and resources on preconception health.

3. Incorporate the socio-ecological environment in preconception health policies, guidelines, and interventions.

Teefey CP, Durnwald CP.

2017 [40]

To discusses the problem of maternal obesity, excessive gestational weight gain, and preexisting diabetes, which are more prevalent in certain racial and ethnic minorities, and suggests strategies to address these disparities through healthy lifestyle interventions and the support of obstetrical providers

I. Review article

1. The paper describes two interventions for gestational weight gain and postpartum weight retention in racial/ethnic minority women:

▪ A technology-based behavioral intervention for low socioeconomic status African American women, including diet and activity goals, weekly weigh-ins, text message reminders, Facebook support, and weekly health coach calls.

▪ A group-based intervention for overweight and obese African American women, involving antenatal group sessions, a postpartum home visit, and phone calls focused on weight monitoring, diet, nutrition support, physical activity, and postpartum weight reduction.