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Obesityinter-actNCT02989142

Inter-pregnAncy Coaching for a Healthy fuTure

A study testing INTER-ACT in people with Obesity and Pregnancy, run by KU Leuven at 6 sites in Belgium.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The project focuses on prevention of major pregnancy and birth related complications : pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), caesarean section (CS), and large-for-gestational-age (LGA), i.e. Read more about this study

Who is it for?
Ages 18 to 45 years, women only
Conditions the study is for
Obesity, Pregnancy
What is being tested?
INTER-ACT
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,100 participants
Where
6 sitesBelgium
Study dates
1 Apr 2017to Sep 2020
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 to 45 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Excessive weight gain during their previous pregnancy (above the IOM recommendations)
  • Child wish for having a next pregnancy
  • Women aged 18 years or more
  • Sufficient fluent in Dutch language
  • Able to give written informed consent
  • Able to use a smartphone. If the women do not have a smartphone because of socio-economic reasons, a smartphone is at her disposal for the whole duration of the intervention, in order to be able to use Apps connected with a Bluetooth pedometer and balance scale.

Who cannot join

  • Requirement for (complex) diets
  • History of or a plan for bariatric surgery
  • Underlying or chronic disorders (e.g. diabetes, thyroid disease, renal diseases)
  • Significant psychiatric disorder
  • Previous still birth

Trial locations and contacts

6 sites in 1 country.

Annick Bogaerts, PhD contact

++3216342810

annick.bogaerts@ucll.be

Roland Devlieger, Phd, MD contact

Roland.Devlieger@med.kuleuven.be

6 sites in 1 country

Belgium6 sites, 6 recruiting
  • UZA

    Antwerp

    Recruiting
  • Ziekenhuizen GasthuisZusters Antwerpen (GZA)

    Antwerp

    Recruiting
  • Ziekenhuis Oost-Limburg (ZOL)

    Genk

    Recruiting
  • Jessa ziekenhuis

    Hasselt

    Recruiting
  • Sint-Franciskusziekenhuis

    Heusden

    Recruiting
  • UZ Leuven

    Leuven

    Recruiting

Other trials in Belgium

About this study

The project focuses on prevention of major pregnancy and birth related complications : pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), caesarean section (CS), and large-for-gestational-age (LGA), i.e. the birth weight of the baby exceeds the 90% percentile of birth weights for the specific pregnancy duration.

The investigators focus on the pre-conception period, i.e. the pre-conception period of the 2nd pregnancy in women with an excessive weight gain during their 1st pregnancy, aiming to decrease the complications rate in their 2nd pregnancy.

Read more

Women with an excessive gestational weight gain have obtained the extra weight during a rather short period of time, e.g. 20 kilos in the last 4 or 5 months of their pregnancy. This characteristic distinguishes the target group from the general population with overweight/obesity, in whom the extra weight was acquired during many years and independent from a pregnancy, making a behaviour change more complex.

The coaching intervention combines face-to-face counselling with the use of a mobile App connected to medical devices (scale and pedometer). The app monitors important indicators (weight, eating behaviour, physical activity, mental wellbeing), provides coaching through established behavioral change techniques, and is specifically tailored for women with excessive weight gain during the previous pregnancy.

The goal is to decrease the rate of pregnancy and birth-related adverse outcomes in the next pregnancy by a healthy life style, starting shortly after their 1st delivery and sustained during the next pregnancy.

Read the detailed description

The aim is to decrease the prevalence of pregnancy and birth-related complications (pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), caesarean section (CS), and large-for-gestational-age babies (LGA)). These complications occur in 26% of pregnancies with normal start BMI and adequate weight gain, in 34% in normal start BMI but excessive gestational weight gain and in up to 66% in obese class III (BMI≥40kg/m²) combined with excessive gestational weight gain. Moreover, as the prevalence of maternal obesity continues to rise, increasing numbers of children are exposed to an 'obesogenic intrauterine environment'. Obesity in pregnancy has therefore the potential to result in an 'intergenerational cycle' of obesity through in utero programming.

The investigators focus on women with excessive weight gain during their 1st pregnancy as currently, half of them do not return to their pre-pregnancy weight before the next pregnancy. This results in a complication rate as high as 42% (PIH, GDM, CS, LGA). The investigators target a healthy BMI at start of pregnancy by intervening during the pre-conception period- and an adequate weight gain during pregnancy by intervening during pregnancy in these women. The intervention will be evaluated in a randomized controlled trial including 1,100 women.

The proposed intervention combines face-to-face coaching with the use of a mobile App (so-called 'inter-act' app) connected to medical devices (scale and pedometer). The app monitors women's weight, eating behaviour, physical activity, mental wellbeing, and provides continuously coaching through positive behavioral change techniques. The 'inter-act' App covers after the 1st delivery breast-feeding support, while during pregnancy, the gestational weight gain guidelines of the Institute of Medicine (IOM) are included.

Drop out of less motivated women is avoided as the time points of the four pre-conception coaching sessions coincide with the existing postnatal follow-up visits for neonates (Governmental vaccination scheme through the organisation " Kind \& Gezin"), and the three pregnancy coaching sessions coincide with the three routine ultrasound scans during normal pregnancy (KCE Guidelines).

Each year, there are 8,900 singleton pregnancies in Flanders in whom the mother had excessive gestational weight gain in the prior pregnancy. The current rate of at least one of the four major pregnancy and birth-related complications (PIH, GDM, CS, LGA) in the 8,900 pregnancies is 42%. If the complications rate reduces with 1/4, this involves more than 900 pregnancies, and reduces costs related to caesarean sections, gestational diabetes, obesity in mother \& child.

Conditions
Obesity, Pregnancy
Being tested
INTER-ACT
Keywords
interpregnancy, pregnancy-induced hypertension, gestational diabetes mellitus, caesarean section, large-for-gestational-age
Medical subject headings
Obesity, Hypertension, Pregnancy-Induced, Diabetes, Gestational

What participants receive

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

  • INTER-ACTBehavioural

    Pre-conception coaching sessions: We encourage less motivated women to participate to the trial by collaborating with Kind \& Gezin from the very beginning, as most timepoints of the counselling sessions coincide with the time points of the Kind\&Gezin vaccine scheme (postpartum week 6, week 8, week 12, 6 months). We will organize the coaching in a "mother and baby friendly" community-based setting or in the hospitals, as preferred by the mothers.

    Pregnancy coaching sessions: take place in hospital, at the time of the three planned ultrasound scans.

    By consequence, the applied methodology can be applied as such at the moment of global utilisation in Flanders.

Study groups in NCT02989142
Study groupRoleWhat they receive
Control armNo interventionNo intervention
INTER-ACT armExperimentalFour pre-conception coaching sessions : postpartum week 6, week 8, week 12, 6 months. Three pregnancy coaching sessions: at the time of the planned ultrasound scans.
Receives: Behavioral: INTER-ACT

What is being measured

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

  1. prevalence of participants with at least one of the following four complications: pregnancy-induced hypertension, gestational diabetes mellitus, caesarean section, large-for-gestational age baby

    The existence of pregnancy-induced hypertension and gestational diabetes mellitus are assessed during pregnancy. Whether the 2nd pregnancy results in a caesarean section and large-for-gestational-age baby will be known at the time of delivery 2nd pregnancy. Therefore, the primary outcome of prevalence of participants with pregnancy and birth-related complications is assessed at the time of delivery 2nd pregnancy.

    Measured: at the time of delivery 2nd pregnancy (max pregnancy duration 44 weeks)

Secondary outcomes (15)
  1. Drop out

    Drop-out rate and reason for drop-out

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  2. Rate of women who returned to their pre-pregnancy weight

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  3. Distribution underweight, normal weight, overweight, obese BMI

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  4. Body composition

    Body composition measured by bio-electrical impedance analysis to estimate fat mass, fat free mass and muscle mass.

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  5. Skin fold measurements

    Skin fold measurements or determining body fat composition by use of a skinfold calliper.

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  6. Breast feeding behaviour

    Breast feeding (BF) habits are assessed by a structured questionnaire on breastfeeding practice. The questionnaire consists of eleven questions in Dutch, which investigates intention to BF, initiation to BF, exclusive BF, combination of bottle-feeding and BF and motives to cease BF.

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  7. Food intake

    food intake is measured by a Food Frequency Questionnaire: frequency of food intake (per day, per week or per month) and portion size (in gram or millilitre).

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  8. Physical activity

    Physical activity is measured using International Physical Activity Questionnaire (IPAQ), long version.

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  9. Life style behaviour

    Life style behaviour: whether the mother is following a diet, smoking, sleep duration and quality of sleep, alcohol use (questionnaire).

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  10. Anxiety

    Anxiety symptoms are measured with the Trait Anxiety Inventory (TAI).

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  11. Depression

    Levels of depression are measured with the reliable and valid 10-item Edinburgh Postnatal Depression Scale (PDS).

    Measured: at 6 months, at 12 months, at 18 months .... till delivery 2nd pregnancy

  12. rate of patients with excessive gestational weight gain during their 2nd pregnancy.

    Measured: at the time of delivery 2nd pregnancy (max pregnancy duration 44 weeks)

  13. Rate of preterm/term pregnancies

    Measured: at the time of delivery 2nd pregnancy (max pregnancy duration 44 weeks)

  14. Cost-effectiveness of the intervention

    Costs related to these complications:

    1. caesarean section costs 4,013€ compared to 2,909€ for a vaginal delivery, resulting in a 4,013-2,909= 1,104€ additional cost per caesarean section (Onafhankelijke Ziekenfondsen, 2012).
    2. Gestational diabetes has an additional cost 820 € (Danyliv et al., IADPSG 2014, Gestational Diabetes and health care cost).
    3. There is also the impact of gestational diabetes on the baby. Intrauterine exposure through gestational diabetes predisposes the off-spring to diabetes: yearly cost for diabetes around 5,800€ (American Diabetes Association).
    4. Obesity: yearly additional direct medical cost for obesity approximately 3000 € per person due to increased contacts with health care providers and hospitalisation costs (De Jonghe E and Annemans L, 2009).

    The costs of the coaching sessions are based on the official nomenclature of midwives (RIZIV - Rijksinstituut voor ziekte- en invaliditeitsverzekering, Belgian institute)

    Measured: at the time of delivery 2nd pregnancy (max pregnancy duration 44 weeks)

  15. Number of women who gave at least 6 months breast feeding

    Measured: at 6 months

Timeline

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

  1. First posted12 Dec 2016 (estimated)
  2. Study start1 Apr 2017
  3. Primary completionMar 2020 (estimated)
  4. Study completionSep 2020 (estimated)

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02989142
Sponsor's protocol ID
T005116N
Acronym
inter-act
Status last verified
Jun 2017
First submitted
29 Aug 2016
Last updated
12 Jun 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Duizer L, Geusens F, Geerits E, Devlieger R, Bogaerts A. Application Usability, Engagement, and Postpartum Weight Retention: Secondary Analysis of the INTER-ACT Randomized Controlled Trial. Mayo Clin Proc Digit Health. 2026 Jun 9;4(3):100381. doi: 10.1016/j.mcpdig.2026.100381. eCollection 2026 Sep.

    PubMed 42441015
  • Van Uytsel H, Ameye L, Devlieger R, Bijlholt M, Van der Gucht K, Jacquemyn Y, Bogaerts A. Effect of the INTER-ACT lifestyle intervention on maternal mental health during the first year after childbirth: A randomized controlled trial. PLoS One. 2023 Jul 28;18(7):e0284770. doi: 10.1371/journal.pone.0284770. eCollection 2023.

    PubMed 37506163
  • Van Uytsel H, Bijlholt M, Devlieger R, Ameye L, Jochems L, van Holsbeke C, Schreurs A, Catry V, Bogaerts A. Effect of the e-health supported INTER-ACT lifestyle intervention on postpartum weight retention and body composition, and associations with lifestyle behavior: A randomized controlled trial. Prev Med. 2022 Nov;164:107321. doi: 10.1016/j.ypmed.2022.107321. Epub 2022 Oct 27.

    PubMed 36309119
  • Bijlholt M, Ameye L, Van Uytsel H, Devlieger R, Bogaerts A. The INTER-ACT E-Health Supported Lifestyle Intervention Improves Postpartum Food Intake and Eating Behavior, but Not Physical Activity and Sedentary Behavior-A Randomized Controlled Trial. Nutrients. 2021 Apr 14;13(4):1287. doi: 10.3390/nu13041287.

    PubMed 33919758
  • Bogaerts A, Ameye L, Bijlholt M, Amuli K, Heynickx D, Devlieger R. INTER-ACT: prevention of pregnancy complications through an e-health driven interpregnancy lifestyle intervention - study protocol of a multicentre randomised controlled trial. BMC Pregnancy Childbirth. 2017 May 26;17(1):154. doi: 10.1186/s12884-017-1336-2.

    PubMed 28549455

Questions about this trial

What is this clinical trial studying?

A study testing INTER-ACT in people with Obesity and Pregnancy, run by KU Leuven at 6 sites in Belgium.

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 6 inclusion and 5 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: status not confirmed, as of the sponsor's last update on 12 Jun 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Belgium. 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?

Results are not available in the source record.

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

Contact Annick Bogaerts, PhD (++3216342810, annick.bogaerts@ucll.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

prevalence of participants with at least one of the following four complications: pregnancy-induced hypertension, gestational diabetes mellitus, caesarean section, large-for-gestational age baby (time frame: at the time of delivery 2nd pregnancy (max pregnancy duration 44 weeks)). 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 NCT02989142, 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 12 Jun 2017.

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