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A Web-Based Lifestyle Intervention for Women With Recent Gestational Diabetes Mellitus: A Randomized Controlled Trial

Nicklas, Jacinda M. MD, MPH; Zera, Chloe A. MD, MPH; England, Lucinda J. MD, MSPH; Rosner, Bernard A. PhD; Horton, Edward MD; Levkoff, Sue E. ScD, MSW; Seely, Ellen W. MD

doi: 10.1097/AOG.0000000000000420
Contents: Original Research

OBJECTIVE: To test the feasibility and effectiveness of a Web-based lifestyle intervention based on the Diabetes Prevention Program modified for women with recent gestational diabetes mellitus to reduce postpartum weight retention.

METHODS: We randomly allocated 75 women with recent gestational diabetes mellitus to either a Web-based lifestyle program (Balance after Baby) delivered over the first postpartum year or to a control group. Primary outcomes were change in body weight at 12 months from 1) first postpartum measured weight; and 2) self-reported prepregnancy weight.

RESULTS: There were no significant differences in baseline characteristics between groups including age, body mass index, race, and income status. Women assigned to the Balance after Baby program (n=36, three lost to follow-up) lost a mean of 2.8 kg (95% confidence interval –4.8 to −0.7) from 6 weeks to 12 months postpartum, whereas the control group (n=39, one lost to follow-up) gained a mean of 0.5 kg (−1.4 to +2.4) (P=.022). Women in the intervention were closer to prepregnancy weight at 12 months postpartum (mean change −0.7 kg; −3.5 to +2.2) compared with women in the control arm (+4.0 kg; +1.3 to +6.8) (P=.035).

CONCLUSION: A Web-based lifestyle modification program for women with recent gestational diabetes mellitus decreased postpartum weight retention.



The Web-based lifestyle intervention program Balance after Baby leads to decreased postpartum weight retention in women with recent gestational diabetes mellitus.

Division of Endocrinology, Diabetes and Hypertension, the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, the Channing Division of Network Medicine, Department of Medicine and the Department of Global Health and Social Medicine, Harvard Medical School, the Department of Biostatistics, Harvard School of Public Health, and the Joslin Diabetes Center, Boston, Massachusetts; the Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado; the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and the College of Social Work, University of South Carolina, Columbia, South Carolina.

Corresponding author: Jacinda M. Nicklas, MD, MPH, MA, Division of General Internal Medicine, University of Colorado School of Medicine, 12348 E Montview Boulevard, C263, Aurora, CO 80045, e-mail:

The Balance after Baby study was supported by the Centers for Disease Control (Cooperative Agreement Number MM-1094–09/09, announcement number CD05-050), and work by the investigators was supported by an Institutional National Research Service Award #T32AT000051 from the National Center for Complementary and Alternative Medicine at the National Institutes of Health and a K24 from the National Heart Lung and Blood Institute at the National Institutes of Health (9K24HL096141).

The authors thank the women who participated in the Balance after Baby trial, the Greater Boston YMCA for providing low-cost memberships for the study, and the Clinical and Informatics cores of the Harvard Clinical and Translational Science Award for providing nursing and laboratory services.

Presented at the Society for General Internal Medicine Annual Meeting, Denver, Colorado, April 26, 2013.

The findings and conclusions are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.