Impact of lifestyle intervention for obese women during pregnancy on maternal metabolic and inflammatory markers

Int J Obes (Lond). 2017 Apr;41(4):598-605. doi: 10.1038/ijo.2017.9. Epub 2017 Jan 17.


Background: Offspring of obese mothers have increased risk of developing obesity and related short- and long-term disease. The cause is multifactorial and may partly be explained by the unfavorable intrauterine environment. Intervention during pregnancy leading to a healthier lifestyle among obese may alter this.

Objective: To assess the effect of lifestyle intervention on markers of maternal metabolism and inflammation in 'the TOP (Treatment of Obese Pregnant Women) study', a randomized controlled trial.

Methods: In the TOP-study 425 participants with body mass index ⩾30 kg/m2 were randomized to intervention with dietary advices and physical activity assessed by pedometer (PA+D), physical activity assessed by pedometer (PA) or control (C). Of 389 participants completing the study 376 had available blood samples. Serum was analyzed for insulin, c-peptide, lipid profile, leptin, high-sensitivity CRP (hsCRP) and Soluble urokinase Plasminogen Activator Receptor (suPAR), in week 18-20 and 28-30, and simultaneously a 2-h oral glucose-tolerance-test was performed. Diet was assessed in gestational week 11-14 and 36-37 using a validated 360-item Food Frequency Questionnaire.

Results: Median levels of hsCRP in gestational week 28-30 were lower in each of the intervention groups (8.3 mg/l in PA+D group, P=0.03; and 8.8 mg/l in PA group, P=0.02) versus the control group (11.5 mg/l). Obtaining 11 000 steps per day as aimed for resulted in a 21% lower hsCRP compared to non-compliant women. Women reporting high carbohydrate intake had around 30% higher hsCRP concentrations in late gestation than women reporting the lowest intake. There were no differences in lipid profile or any of the metabolic markers in gestational week 28-30 when comparing the intervention and control groups.

Conclusions: Lifestyle intervention in obese women can reduce hsCRP representing a marker of inflammation during pregnancy. The effect may partly be mediated by more physical activity and partly by changes in intake of carbohydrates and the glycaemic load.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Biomarkers / metabolism*
  • Blood Glucose / metabolism
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Energy Intake / physiology
  • Exercise
  • Female
  • Glucose Tolerance Test
  • Humans
  • Inflammation / blood*
  • Insulin / blood
  • Interleukin-6 / blood
  • Leptin / blood
  • Netherlands
  • Obesity / blood
  • Obesity / metabolism*
  • Obesity / physiopathology
  • Obesity / prevention & control*
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / metabolism*
  • Pregnancy Complications / physiopathology
  • Pregnancy Complications / prevention & control*
  • Risk Reduction Behavior*
  • Weight Gain


  • Biomarkers
  • Blood Glucose
  • Insulin
  • Interleukin-6
  • Leptin
  • C-Reactive Protein