Research Summary

Analyzed using Evidence Intelligence™

Preconception lifestyle intervention shows little effect on neonatal outcomes

Last updated July 17, 2026

Key finding

21% (11/53) of infants in the intervention group and 28% (15/53) in the control group had birth weight > 4 kg (p = 0.367).

This study evaluated the impact of a preconception lifestyle intervention on neonatal outcomes, finding no significant differences between intervention and control groups.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

This study evaluated the impact of a preconception lifestyle intervention on neonatal outcomes, finding no significant differences between intervention and control groups.

Clinical relevance

Understanding the effectiveness of preconception lifestyle interventions is crucial for improving maternal and neonatal health. This study's findings suggest that such interventions may not lead to significant improvements in neonatal outcomes, which could influence future health recommendations and interventions aimed at expecting parents.

Keep in mind

Small sample size may limit generalizability. No significant differences found, indicating unclear effectiveness. Results may not apply to broader populations outside the study.

Published in

Journal Reference

Publication details and source links for this paper.

Md AJS, Hanna S, Guro R, et al. Effect of a Preconception Lifestyle Intervention on Neonatal Outcomes: A Secondary Analysis of the BEFORE THE BEGINNING Trial. Nutrients. 2025;17(21):3492. doi:10.3390/nu17213492

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Main Effects

21% of infants in the intervention group had birth weight > 4 kg compared to 28% in the control group (p = 0.367).

Mean birth weight difference was -159.3 g (p = 0.148), indicating no significant difference.

APGAR scores < 7 at 5 min were 0% in the intervention group versus 2% in the control group.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Complex lifestyle intervention and Frequency of infants with APGAR score less than 7 at 5 minutes after birth, Gestational age at delivery (weeks), Length of hospital stay, and 4 more.

This study contributes evidence to

Intervention

Complex lifestyle intervention

Outcome

Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Evidence topic

Diabetes Self-Management Education and Support

Primary intervention

Complex lifestyle intervention

Primary outcomes

Frequency of infants with APGAR score less than 7 at 5 minutes after birth
Gestational age at delivery (weeks)
Length of hospital stay

Evidence topics

Diabetes Self-Management Education and Support

Primary intervention

Complex lifestyle intervention

Primary outcomes

Frequency of infants with APGAR score less than 7 at 5 minutes after birth Gestational age at delivery (weeks)Length of hospital stay

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

Evidence pairs

Relationships

Evidence topics

contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 63

Why it is useful

Contributes to 7 evidence relationships
Includes primary outcome data
Linked to 1 direct semantic evidence topic

Topic contributions

Evidence topic

Contributes evidence

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Primary evidence

Evidence topic

Diabetes Self-Management Education and Support

matched_intervention

Core evidence

Study findings

The primary outcomes reported in this study.

Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Complex lifestyle intervention → Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Gestational age at delivery (weeks)

Complex lifestyle intervention → Gestational age at delivery (weeks)

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Length of hospital stay

Complex lifestyle intervention → Length of hospital stay

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Mode of delivery outcomes

Complex lifestyle intervention → Mode of delivery outcomes

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Neonatal birth weight

Complex lifestyle intervention → Neonatal birth weight

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of infants with birth weight greater than 4 kg

Complex lifestyle intervention → Proportion of infants with birth weight greater than 4 kg

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Rate of preterm delivery (<37 weeks)

Complex lifestyle intervention → Rate of preterm delivery (<37 weeks)

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Evidence Library

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Evidence Suggest

No significant difference in birth weight between groups (p = 0.148).
Both groups had similar APGAR scores at 5 min.
Gestational age at birth was comparable between intervention and control.

Who this applies to

Women planning to conceive who may consider lifestyle interventions.
Healthcare providers advising on preconception health.

Keep in Mind

The study's findings are based on a small participant group.
The intervention's effectiveness remains unclear due to non-significant results.
Further research is needed to explore potential benefits of lifestyle interventions.

Between the Lines

Small sample size may limit generalizability.
No significant differences found, indicating unclear effectiveness.
Results may not apply to broader populations outside the study.

Evidence Library

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Connected Evidence

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Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and Frequency of infants with APGAR score less than 7 at 5 minutes after birth, Diabetes Self-Management Education and Support (DSMES) Programs and Proportion of infants with birth weight greater than 4 kg.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Behavioral & Lifestyle

Detailed evidence

Diabetes Self-Management Education and Support (DSMES) Programs → Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Behavioral & Lifestyle

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

View evidence

Behavioral & Lifestyle

Detailed evidence

Diabetes Self-Management Education and Support (DSMES) Programs → Proportion of infants with birth weight greater than 4 kg

Behavioral & Lifestyle

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

View evidence

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Diabetes Self-Management Education and Support (DSMES) Programs Evidence Hub

All studies on Diabetes Self-Management Education and Support (DSMES) Programs

1 studies

intervention_hub

Contributes to Diabetes Self-Management Education and Support (DSMES) Programs evidence base.

Frequency of infants with APGAR score less than 7 at 5 minutes after birth Evidence Hub

All studies measuring Frequency of infants with APGAR score less than 7 at 5 minutes after birth

1 studies

outcome_hub

Measures Frequency of infants with APGAR score less than 7 at 5 minutes after birth as a key outcome.

Proportion of infants with birth weight greater than 4 kg Evidence Hub

All studies measuring Proportion of infants with birth weight greater than 4 kg

1 studies

outcome_hub

Measures Proportion of infants with birth weight greater than 4 kg as a key outcome.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Explore more in Evidence Explorer

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All studies on Complex lifestyle intervention and Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Intervention: Complex lifestyle interventionOutcome: Frequency of infants with APGAR score less than 7 at 5 minutes after birth

1 results

All studies on Complex lifestyle intervention and Proportion of infants with birth weight greater than 4 kg

Intervention: Complex lifestyle interventionOutcome: Proportion of infants with birth weight greater than 4 kg

1 results

All studies on Complex lifestyle intervention

Intervention: Complex lifestyle intervention

1 results

All studies measuring Frequency of infants with APGAR score less than 7 at 5 minutes after birth

Outcome: Frequency of infants with APGAR score less than 7 at 5 minutes after birth

1 results

All studies measuring Proportion of infants with birth weight greater than 4 kg

Outcome: Proportion of infants with birth weight greater than 4 kg

1 results

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Complex lifestyle intervention improve frequency of infants with apgar score less than 7 at 5 minutes after birth?

Emerging Evidence

Current evidence does not show a clear benefit of Complex lifestyle intervention for Frequency of infants with APGAR score less than 7 at 5 minutes after birth.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Frequency of infants with APGAR score less than 7 at 5 minutes after birth
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Complex lifestyle intervention improve gestational age at delivery (weeks)?

Emerging Evidence

Current evidence does not show a clear benefit of Complex lifestyle intervention for Gestational age at delivery (weeks).

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Gestational age at delivery (weeks)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Complex lifestyle intervention improve length of hospital stay?

Emerging Evidence

Current evidence does not show a clear benefit of Complex lifestyle intervention for Length of hospital stay.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Length of hospital stay
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Complex lifestyle intervention improve mode of delivery outcomes?

Emerging Evidence

Current evidence does not show a clear benefit of Complex lifestyle intervention for Mode of delivery outcomes.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Mode of delivery outcomes
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

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Next steps

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Evidence topics

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Diabetes Self-Management Education and Support Evidence Hub

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All studies on Complex lifestyle intervention and Proportion of infants with birth weight greater than 4 kg All studies on Complex lifestyle intervention and Frequency of infants with APGAR score less than 7 at 5 minutes after birth All studies on Complex lifestyle intervention and Gestational age at delivery (weeks)All studies on Complex lifestyle intervention and Length of hospital stay

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