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ObesityPEARLSNCT01771133

Pregnancy and EARly Lifestyle Improvement Study

A study testing Lifestyle intervention group in people with Obesity and Hyperglycemia, run by University of Puerto Rico at 1 site in Puerto Rico.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The investigators propose to conduct a randomized controlled trial in 200 overweight/obese pregnant women and their offspring. The prenatal intervention will emphasize improving diet and physical activity. Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Obesity, Hyperglycemia
What is being tested?
Lifestyle intervention group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
1 sitePuerto Rico
Study dates
Jan 2013to Nov 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Singleton viable pregnancy. A twin pregnancy reduced to singleton before 14 weeks by project gestational age is acceptable. 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 that compares the last menstrual period (LMP) date and data from the earliest ultrasound.*
  • BMI ≥25 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. Reported pre-pregnancy weight will not be used to determine eligibility because of the potential for inaccuracy. If the earliest weight measurement is conducted at 140 to 146 weeks or 150 to 156 weeks, 1 lb or 2 lbs will be subtracted from the measured weight respectively, to adjust to a first trimester weight.*
  • Age ≥ 18*

Who cannot join

  • Diagnosis of diabetes prior to pregnancy (reported physician diagnosed diabetes other than GDM in previous pregnancy or taking insulin or medications to treat diabetes), or an HbA1c ≥ 6.5 % or other test result (elevated fasting glucose ≥126 mg/dL/7.0 mmol/L or 2 h glucose ≥200 mg/dL/11.1 mmol/L when OGTT is completed) suggestive of pre-pregnancy diabetes. All potential participants will have HbA1c performed prior to randomization.*
  • Known fetal anomaly *
  • Planned termination of pregnancy*
  • History of three or more consecutive first trimester miscarriages*
  • Past history of anorexia or bulimia by medical history or patient report. Binge eating disorder is not an exclusion*
  • Current eating disorder diagnosed by EDE-Q questions 2-4 and confirmed after discussion with the participant by study staff*
Show all 33Show fewer
  • Actively suicidal defined as a value ≥ 2 on the BDI-II question 9*
  • Prior or planned (within 1 year of expected delivery) bariatric surgery*
  • Current use of one or more of the following medications: *
  • Metformin
  • Systemic steroids
  • Antipsychotic agents
  • Anti-seizure medications or mood stabilizers that would be expected to have a significant impact on body weight
  • Medications for ADHD including amphetamines and methylphenidate
  • Continued use of weight loss medication including OTC and dietary supplements for weight loss *
  • Contraindications to aerobic exercise in pregnancy specified in the ACOG Committee Opinion #267, 2002 (reaffirmed 2009) *
  • Hemodynamically significant heart disease defined as an AHA class II (short of breath with exercise) or greater
  • Restrictive lung disease (e.g. pulmonary fibrosis)
  • Poorly controlled seizure disorder
  • Poorly controlled hypertension (blood pressure ≥160/110)
  • History of extreme sedentary lifestyle (e.g. bed bound)
  • Orthopedic limitations to aerobic exercise
  • Severe anemia defined as a hemoglobin < 8 g/dl or hematocrit <24 %
  • Participation in another interventional study that influences weight control*
  • Enrollment in this trial in a previous pregnancy*
  • Intention of the participant or of the care provider for the delivery to be outside the LIFE-Moms Consortium hospital*
  • Participant's unwillingness or inability to commit to a 1 year follow-up of herself or her child, including planning to move away*
  • Past or current intravenous drug use (visual check for injection marks, recorded methadone use, self-report)
  • Self-reported HIV infection (confirmed from medical records or baseline test results)
  • Inability to functionally participate in group sessions and other study requirements on a regular basis during the complete duration of the study, including but not limited to the documented use of the accelerometer for the periods required by the study
  • Non Spanish speaking
  • Plan on giving up infant for adoption
  • '' Core eligibility criterion for the LIFE-Moms Consortium

Trial locations and contacts

1 site in 1 country.

Puerto Rico1 site
  • University of Puerto Rico Medical Science Campus

    San Juan, 00935

Other trials in Puerto Rico

About this study

The investigators propose to conduct a randomized controlled trial in 200 overweight/obese pregnant women and their offspring. The prenatal intervention will emphasize improving diet and physical activity. The lifestyle intervention will be delivered within an empowerment theoretical framework through a combination of group sessions, individual counseling, and by monitoring compliance to diet and physical activity to further tailor the intervention. The post-partum intervention sessions will include mothers and their offspring and will focus on breastfeeding, improving physical activity and quality of the diet and feeding practices through the first post-partum year. As part of routine prenatal care, participants in both the control and intervention arms will be given health-related advice. Since the majority of participants are expected to be eligible for the Women, Infants and Children (WIC) program, both groups will also receive assistance through WIC as per their routine policies. Our primary outcome is Gestational Weight Gain (GWG). The major secondary outcome of interest is infant BMI z-score at 12 months of age, and the investigators will also be evaluating several metabolic outcomes in mothers and infants.

Read the detailed description

Obesity and hyperglycemia in pregnancy are thought to impact fetal growth through over-nutrition and may stress the fetal pancreas because of the increased demand for insulin. Such intrauterine programming events affect birth weight and raise the offspring's risk trajectory for future obesity, type 2 diabetes, cardiovascular disease and premature death. Investigators propose to conduct a randomized controlled trial in 200 overweight or obese pregnant Puerto Rican women (free of diabetes) and their infants, to favorably impact metabolic health in mothers and infants.

Women presenting will be randomized to a lifestyle modification intervention or standard care control group before 16 gestational weeks. The intervention will focus on improving: (1) physical activity levels and (2) diet quality and calorie intake. The lifestyle intervention will be delivered within an empowerment theoretical framework through individualized intervention sessions, intensive group sessions, and by phone calls. The intervention will continue through the first postpartum year and will include the infants. A key objective is to evaluate whether the intervention optimizes infant BMI z-score. We will also evaluate whether the intervention increases the number of women who experience appropriate gestational weight gain, and evaluate several additional aims including relating the interventions with improved insulin sensitivity and beta-cell function in the women, and insulin concentrations adjusted for glucose in their infants.This study will also help us to identify and overcome barriers to develop effective ways of intervening during pregnancy to meaningfully improve cardio-metabolic risk trajectories of future generations.

Being tested
Lifestyle intervention group
Keywords
Obesity, Maternal Welfare, Child Welfare, Nutritional Sciences, Clinical Trial, Pregnancy, Physical activity, Fetal Development, Metabolic Diseases, Life style, Behavior and Behavior Mechanisms, LIFE-Moms
Medical subject headings
Obesity, Hyperglycemia, Motor Activity, Metabolic Diseases, Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lifestyle intervention groupBehavioural

    The lifestyle intervention will be delivered within an empowerment framework which promotes behavioral changes by facilitating health self-efficacy, utilizing self-praise and using active coping skills to address and manage emotions. A nutrition component primarily focuses on total calories, for which energy requirements will be individually calculated for each pregnant women and on general diet quality with an emphasis on carbohydrate quality. It will also promote an overall healthy diet, emphasizing improvement of fat quality and reducing salt intake. A physical activity component focuses on promoting regular movement and minimizes the duration of bouts of sitting or lying during waking hours as well as non-exercise activity.

Study groups in NCT01771133
Study groupRoleWhat they receive
Lifestyle and nutrition control groupNo interventionThe control arm will receive routine prenatal care in the prenatal clinic. They will receive regular phone calls and mailings, token gifts and some useful information from data collected in the study, such as physical activity, feedback on behavior throughout the study. To additionally promote adherence (since they will have less contact with study staff), we will include 2 pre-partum and 1 post-partum group sessions meant to increase bonding between participants and retention of control participants. These sessions will include general pregnancy information not related to our interventions.
Lifestyle intervention groupActive comparatorThe lifestyle intervention will be delivered within an empowerment framework which promotes behavioral changes by facilitating health self-efficacy, utilizing self-praise and using active coping skills to address and manage emotions. A nutrition component primarily focuses on total calories, for which energy requirements will be individually calculated for each pregnant women and on general diet quality with an emphasis on carbohydrate quality. It will also promote an overall healthy diet, emphasizing improvement of fat quality and reducing salt intake. A physical activity component focuses on promoting regular movement and minimizes the duration of bouts of sitting or lying during waking hours as well as non-exercise activity.
Receives: Behavioral: Lifestyle intervention group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Gestational Weight Gain

    To determine if a combined lifestyle intervention of nutrition and physical activity delivered within an empowerment theoretical framework in pregnant women result in a greater percent of women who gain the appropriate amount of gestational weight gain, as defined by the Institute of Medicine, compared to those receiving standard care.

    Measured: Delivery

Secondary outcomes (17)
  1. Does the lifestyle intervention (compared with control) affect the infant BMI z-score at 12 months of age (major

    To evaluate whether the intervention influences infant BMI by comparison of infants of mothers randomized to either active intervention or control intervention

    Measured: 12 months post-partum

  2. Estimates of beta-cell function and insulin action in the mother.

    Estimation of beta-cell function, insulin resistance, and insulin sensitivity using data obtained from a frequently sampled 75g OGTT. Calculations will be based on established equations that have been validated for use in pregnancy, such as the model-based approach and the oral disposition index.

    Measured: 35,0-36,6 wks 48,0-56,0 wks pp

  3. Maternal blood pressure during pregnancy

    Measured: 24,0-27,6 wks; 35,0-36,6 wks; Delivery

  4. Maternal blood pressure postpartum.

    Measured: 4,0-6,0 wks pp; 16,0-24,0 wks pp; 48,0-56,0 wks pp

  5. Infant blood pressure

    Measured: < 48 hour pp; 4-6 wks pp; 16-24 wks pp

  6. Post-partum weight retention

    Measured: 4,0-6,0 wks pp; 16,0-24,0 wks pp; 48,0-56,0 wks pp

  7. Body circumferences in mothers

    Measured: 24,0-27,6 wks 35,0-36,6 wks 4,0-6,0 wks pp; 16,0-24,0 wks pp; 48,0-56,0 wks pp

  8. Body circumferences in infants

    Measured: < 48 hour pp 4-6 wks pp 16-24 wks pp 48-56 wks pp

  9. Skinfold measures in infants

    Measured: < 48 hour pp 16-24 wks pp 48-56 wks pp

  10. Sleep quality and duration in the prenatal periods in mothers

    Sleep quality and duration will be assessed using an accelerometer in order to assess duration and quality of sleep

    Measured: 35,0-36,6 wks

  11. Sleep quality and duration in the postpartum periods in mothers and infants

    Sleep quality and duration will be assessed using an accelerometer in order to assess duration and quality of sleep

    Measured: 48,0-56,0 wks pp

  12. Insulin levels adjusted for glucose levels in the infants

    Measured: < 48 hour pp 16-24 wks pp 48-56 wks pp

  13. Developmental measures in infants

    Measured: < 48 hour pp 16-24 wks pp 48-56 wks pp

  14. Anthropometric and growth measures in the infants

    Measured: < 48 hour pp 4-6 wks pp 16-24 wks pp 48-56 wks pp

  15. Psychosocial measures in the mothers

    Measured: 35,0-36,6 wks 48,0-56,0 wks pp

  16. Pregnancy and Delivery complications

    Measured: 35,0-36,6 wks delivery

  17. Fetal and neonatal adverse outcomes

    Measured: Birth and < 48 hour pp

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jan 2013 (estimated)
  2. Study startJan 2013
  3. Primary completionNov 2015
  4. Study completionNov 2015

Why it stopped: recruiting or enrolling participants has halted prematurely by Life-Moms Consortium and will not resume; participants are no longer being examined or treated.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01771133
Sponsor's protocol ID
1U01HD072834
Other IDs
U01HD072834
Acronym
PEARLS
Status last verified
Oct 2016
First submitted
15 Jan 2013
Last updated
28 Oct 2016
Results posted
No
Data monitoring committee
Yes

Publications

  • Cabre HE, Drews KL, Pomeroy J, Keadle SK, Arteaga SS, Franks PW, Haire-Joshu D, Knowler WC, Pi-Sunyer X, Van Horn L, Wing RR, Cahill AG, Clifton RG, Couch KA, Gallager D, Josefson JL, Joshipura K, Klein S, Martin CK, Peaceman AM, Phelan S, Thom EA, Redman LM; LIFE-Moms Research Group. LIFE-Moms: effects of multicomponent lifestyle randomized control trial on physical activity during pregnancy in women with overweight and obesity. Int J Behav Nutr Phys Act. 2025 Sep 30;22(1):119. doi: 10.1186/s12966-025-01805-9.

    PubMed 41029405
  • Flanagan EW, Drews KL, Cade WT, Franks PW, Gallagher D, Phelan S, Van Horn L, Redman LM. Metabolic Health and Heterogenous Outcomes of Prenatal Interventions: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025 Aug 1;8(8):e2528264. doi: 10.1001/jamanetworkopen.2025.28264.

    PubMed 40839263
  • Redman LM, Drews KL, Klein S, Horn LV, Wing RR, Pi-Sunyer X, Evans M, Joshipura K, Arteaga SS, Cahill AG, Clifton RG, Couch KA, Franks PW, Gallagher D, Haire-Joshu D, Martin CK, Peaceman AM, Phelan S, Thom EA, Yanovski SZ, Knowler WC; LIFE-Moms Research Group. Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium. Diabetes Res Clin Pract. 2021 Jan;171:108549. doi: 10.1016/j.diabres.2020.108549. Epub 2020 Nov 22.

    PubMed 33238176
  • Peaceman AM, Clifton RG, Phelan S, Gallagher D, Evans M, Redman LM, Knowler WC, Joshipura K, Haire-Joshu D, Yanovski SZ, Couch KA, Drews KL, Franks PW, Klein S, Martin CK, Pi-Sunyer X, Thom EA, Van Horn L, Wing RR, Cahill AG; LIFE-Moms Research Group. Lifestyle Interventions Limit Gestational Weight Gain in Women with Overweight or Obesity: LIFE-Moms Prospective Meta-Analysis. Obesity (Silver Spring). 2018 Sep;26(9):1396-1404. doi: 10.1002/oby.22250. Epub 2018 Sep 6.

    PubMed 30230252
  • Clifton RG, Evans M, Cahill AG, Franks PW, Gallagher D, Phelan S, Pomeroy J, Redman LM, Van Horn L; LIFE-Moms Research Group. Design of lifestyle intervention trials to prevent excessive gestational weight gain in women with overweight or obesity. Obesity (Silver Spring). 2016 Feb;24(2):305-13. doi: 10.1002/oby.21330. Epub 2015 Dec 26.

    PubMed 26708836

Questions about this trial

What is this clinical trial studying?

A study testing Lifestyle intervention group in people with Obesity and Hyperglycemia, run by University of Puerto Rico at 1 site in Puerto Rico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 33 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 28 Oct 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Puerto Rico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: recruiting or enrolling participants has halted prematurely by Life-Moms Consortium and will not resume; participants are no longer being examined or treated.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Gestational Weight Gain (time frame: Delivery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01771133, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2016.

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