अमूर्त

Time to pregnancy after a pre-pregnancy VLED program in women with obesity: sub-study of a randomized controlled trial

Dr Sarah Price

Statement of the Problem: Around one in five women of reproductive age have obesity at the time of conception. Obesity is known to reduce fertility and prolong time to conception. Multiple national guidelines advise women with obesity to lose weight before conception. However, the amount of weight loss required to overcome the impacy of obesity on time to conception is not known. Methodology & Theoretical Orientation: We conducted a two-arm parallel group randomized controlled trial. 164 normoglycaemic women aged 18-38 years old with a BMI 30-55kg/m2 who were planning pregnancy were recruited via a social media platform. Women were allocated to a 12-week standard dietary intervention or modified VLED. Completers of the intervention were observed for up to 48 weeks and time to pregnancy was recorded. The prespecified exploratory outcome for the substudy was time to pregnancy between the end of the 12-week intervention and the date of conception. Findings: Maternal weight loss at the end of the 12-week intervention was 3.1% in the SDI group and 11.9% in the VLED group. In completers, time to pregnancy was significantly shorter in women allocated to the VLED group than the SDI group. Post hoc analysis showed the difference in time to conception was particularly overt within 90 days of the intervention. Conclusion & Significance: A VLED program that achieves substantial weight loss before pregnancy reduces time to conception compared with a standard dietary intervention in women with obesity. These data have significant implications for women with obesity. Women may be concerned about delaying conception to lose weight because of advanced maternal age or co-morbidities. These data suggest that in women with obesity, a short-duration weight loss study may result in a shorter time to conception than if conception was attempted without weight loss.