Overview

• Researchers analyzed data from the Lifestyle Interventions for Expectant Moms randomized trial to compare outcomes by maternal metabolic status among pregnant participants with obesity.
• Metabolically unhealthy participants developed gestational diabetes at 24% versus 10% for metabolically healthy peers, despite gaining nearly 37% less weight during pregnancy.
• Newborns of mothers classified as metabolically unhealthy had higher adiposity than those born to metabolically healthy mothers.
• The lifestyle program began late in the first trimester and produced similar responses across metabolic subgroups, pointing to the need for earlier, metabolism-focused strategies.
• Authors recommend shifting prenatal care toward screening and managing glucose and lipid levels, while noting the findings come from a secondary analysis that warrants confirmation in future trials.