Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

This systematic review of systematic reviews investigated the effectiveness of lifestyle weight management interventions for postnatal women. We systematically reviewed Medline (PubMed), Embase, CINAHL Plus, The Cochrane Library, and Scopus from 2000 until January 2018, to identify systematic reviews of randomized controlled trials that evaluated the effectiveness of behavioural lifestyle interventions for weight management in postnatal women. Results were summarized both descriptively and statistically using a mega meta-analysis of data from randomized controlled trials included in previous systematic reviews. Nine systematic reviews met our inclusion criteria. Overall the reviews concluded that lifestyle interventions involving physical activity and/or dietary changes resulted in a reduction in postnatal weight. Results from the overall mega meta-analysis confirmed this finding with a mean difference of -1.7 kg (95% CI, -2.3 to -1.1). Findings for subgroup analyses gave mean differences of -1.9 kg (95% CI, -2.9 to -1.0) for combined diet and physical activity interventions, -1.6 kg (95% CI, -2.1 to -1.2) for physical activity-only interventions, and -9.3 kg (95% CI, -16.5 to -2.1) for diet-only interventions (one study). Heterogeneity varied from 0% to 68%. Interventions involving lifestyle interventions appeared to be effective in reducing weight in postnatal women, although these findings should be interpreted with some caution due to statistical heterogeneity.