Prenatal and pediatric primary care–Based child obesity prevention program: A randomized trial

Mary Jo Messito, Alan L. Mendelsohn, Michelle W. Katzow, Marc A. Scott, Sarvenaz Vandyousefi, Rachel S. Gross

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To determine impact of a primary care–based child obesity prevention intervention beginning during pregnancy on early childhood weight outcomes in low-income Hispanic families. METHODS: A randomized controlled trial comparing mother–infant pairs receiving either standard care or the Starting Early Program providing prenatal and postpartum nutrition counseling and nutrition parenting support groups targeting key obesity-related feeding practices in low-income groups. Primary outcomes were reduction in weight-for-age z-scores (WFAzs) from clinical anthropometric measures, obesity prevalence (weight for age $95th percentile), and excess weight gain (WFAz trajectory) from birth to age 3 years. Secondary outcomes included dose effects. RESULTS: Pregnant women (n = 566) were enrolled in the third trimester; 533 randomized to intervention (n = 266) or control (n = 267). Also, 358 children had their weight measured at age 2 years; 285 children had weight measured at age 3 years. Intervention infants had lower mean WFAz at 18 months (0.49 vs 0.73, P = .04) and 2 years (0.56 vs 0.81, P = .03) but not at 3 years (0.63 vs 0.59, P = .76). No group differences in obesity prevalence were found. When generalized estimating equations were used, significant average treatment effects were detected between 10-26 months (B = 20.19, P = .047), although not through age 3 years. In within group dose analyses at 3 years, obesity rates (26.4%, 22.5%, 8.0%, P = .02) decreased as attendance increased with low, medium, and high attendance. CONCLUSIONS: Mean WFAz and growth trajectories were lower for the intervention group through age 2 years, but there were no group differences at age 3. Further study is needed to enhance sustainability of effects beyond age 2.

Original languageEnglish (US)
Article numbere20200709
Issue number4
StatePublished - Dec 1 2020


  • Adult
  • Child, Preschool
  • Female
  • Hispanic Americans
  • Humans
  • Infant
  • Infant, Newborn
  • New York City
  • Pediatric Obesity/ethnology
  • Postnatal Care
  • Poverty
  • Pregnancy
  • Pregnant Women/education
  • Prenatal Care
  • Weight Gain

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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