The effectiveness of behavioral modification interventions for managing weight gain in pregnant women with overweight or obesity: a systematic review and Bayesian network meta-analysis

Global obesity prevalence among pregnant women is associated with adverse health outcomes for both the mother and the infant. This study aims to evaluate the efficacy of a behavioural intervention management model for controlling gestational weight gain (GWG) in pregnant women with overweight or obesity. The quality of the evidence was assessed using the Confidence In Network Meta-Analysis technique. Moreover, a Bayesian network meta-analysis summarised the comparative efficacy of various intervention methods on GWG outcomes. The analysis included 24 trials with 11,008 participants across three different management models: in-person, remote (electronic health (eHealth) or mobile health (mHealth)), and mixed. Evidence quality ranged from very low to high. The multi-behavioural intervention delivered via a blended in-person and mHealth model demonstrated the highest likelihood of being in the top ranks of intervention effectiveness compared to the other interventions included in the analysis, scoring 85.9%. The multi-behavioural intervention delivered via a blended in-person and mHealth administration mode ranked highest in effectiveness for reducing GWG in pregnant women with overweight or obesity compared to the other interventions included in the analysis. Future studies may focus on addressing evidence gaps through more rigorous and direct comparative analyses.