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Purpose To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention. Methods The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5–10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion. Results Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05–1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01–1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p

Objective. To determine the accuracy of near-patient and laboratory- based fetal lung maturity tests in predicting the need for neonatal ventilation.Design. A prospective descriptive study. Subjects. One hundred high-risk obstetric patients where confirmation of fetal lung maturity would initiate delivery.Methods. Fetal weight estimation, placental maturity grading, and amniocentesis were performed. The investigators examined the amniotic fluid visually, and performed the tap test and shake test. Laboratory technicians estimated the lecithin-sphingomyelin (L/S) ratio, determined the presence of a phosphatidyl glycerol (PG) band on gel electrophoresis, and the optical density at 650 nm. Neonates delivered within 1 week of amniocentesis were included in the analysis. The primary end-point was the ability of the lung maturity tests to predict the need for neonatal ventilation.Results. Twelve of 100 neonates required ventilation. The tap test and optical density (OD) shift at 650 nm predicted the need for neonatal ventilation with the greatest accuracy.Conclusion. The tap test is a rapid, easy and accurate predictor of the need for neonatal ventilation. The OD shift at 650 nm is the laboratory-based test with the greatest accuracy in our setting.

STUDY QUESTION: Do age, ovulatory status, severity of obesity and body fat distribution affect the effectiveness of lifestyle intervention in obese infertile women? SUMMARY ANSWER: We did not identify a subgroup in which lifestyle intervention increased the healthy live birth rate however it did increase the natural conception rate in anovulatory obese infertile women. WHAT IS KNOWN ALREADY: Obese women are at increased risk of infertility and are less likely to conceive after infertility treatment. We previously demonstrated that a 6-month lifestyle intervention preceding infertility treatment did not increase the rate of healthy live births (vaginal live birth of a healthy singleton at term) within 24 months of follow-up as compared to prompt infertility treatment in obese infertile women. Natural conceptions occurred more frequently in women who received a 6-month lifestyle intervention preceding infertility treatment. STUDY DESIGN, SIZE, DURATION: This is a secondary analysis of a multicentre RCT (randomized controlled trial), the LIFEstyle study. Between 2009 and 2012, 577 obese infertile women were randomly assigned to a 6-month lifestyle intervention followed by infertility treatment (intervention group) or to prompt infertility treatment (control group). Subgroups were predefined in the study protocol, based on frequently used cut-off values in the literature: age (≥36 or

The prevalence of overweight individuals in The Netherlands is increasing sharply as has also been observed in populations worldwide. In addition to the long-term health risks of being overweight, overweight women of reproductive age are more commonly faced with reproductive disorders. Women who are overweight are less fertile than women of normal weight. The chances of both spontaneous conception and conception after ovulation induction and assisted reproduction are lower in women who are overweight. The chance of a live birth is also decreased due to an increased risk of miscarriage. Furthermore pregnancy outcome is compromised by obesity-related complications of pregnancy. Weight loss of 5-15% in subfertile women who are overweight increases the chance of spontaneous conception and conception after fertility treatment and can be achieved through a low-calorie diet, increased exercise and behaviour modification