Electronic Monitoring of Mom’s Schedule (eMOMS): a Feasibility Randomized Controlled Trial to Improve Postpartum Weight and Lactation Among a Population with Elevated Body Mass Index in a Great Plains Rural State

Background: Rising trends in obesity contribute to maternal and neonatal morbidity and mortality. Nearly 3 in 10 U.S. women have pre-pregnancy obesity associated with developing diabetes during/after pregnancy. Lifestyle modifications and lactation longevity may reverse this effect, though few studies have combined these into one intervention.

Study Purpose: To quantify intervention uptake, and measure weight and lactation duration.

Methods: The electronic Monitoring Of Mom’s Schedule study (eMOMS) was a feasibility, three-arm, multi-center randomized controlled trial (NCT04021602) examining lifestyle changes modelled after the Diabetes Prevention Program (DPP) and lactation (LC) support alone, and in combination. A health-coach (HC) delivered the 12-month intervention that included three groups: DPP+LC+HC, DPP+HC, and attention comparison (HC). Bootstrap samples with 95% confidence intervals, and Wilcoxon signed-ranks exact test reporting from a two-sided test were used.

Results: Between Sept. 2019 and May 2021, 100 individuals were screened, 47 were eligible, and 35 were randomized: 9 to DPP+LC+HC, 14 to DPP+HC, and 12 to HC. At baseline, participants averaged 12.9 (±2.5) weeks gestation, mean pre-pregnancy BMI of 29.9 (±2.9). With 5,000 bootstrap samples, mean weight retention from baseline to 6 months postpartum: 8.9 lbs. (3.6, 13.7) for DPP+LC+HC; 8.1 lbs. (-4.0, 21.7) for DPP+HC; and 16.5 lbs. (9.1, 25.5) for HC; mean lactation duration through 6 months - 11.3 weeks (1.3, 21.2); 14.9 weeks (9.9, 20.0); and 16.7 weeks (9.4, 23.3) for each group respectively. Statistically significant increases in breast/chest-feeding knowledge were observed. Intervention completion rate was 74.3%.

Conclusion: Lifestyle changes and health-coaching positively impact postpartum weight and lactation duration.

Publication: Not applicable.

Diversity and Inclusion: This presentation's content is inclusive of varying work, cultural, and geographic settings; varying sexual orientation, gender identities/expressions, and family structures; varying experiences, expertise, and viewpoints; and will reflect the language and references from a variety of social groups and countries.

This study was also supported by the authors:
Hayrettin Okut – Research Professor, Kansas University School of Medicine-Wichita
Christie Befort – Professor, University of Kansas Medical Center