Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial.
Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial.
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DOI：
10.1002/oby.20831
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发表时间：
2014-09
期刊：
影响因子：
6.9
通讯作者：
Stevens, Victor J.
中科院分区：
文献类型：
--
作者：
Vesco, Kimberly K.;Karanja, Njeri;King, Janet C.;Gillman, Matthew W.;Leo, Michael C.;Perrin, Nancy;McEvoy, Cindy T.;Eckhardt, Cara L.;Smith, K. Sabina;Stevens, Victor J.
观察性研究表明，最小的妊娠期体重增加（GWG）可能会优化肥胖妇女的妊娠结局。该试验测试了基于组的体重管理干预对限制肥胖妇女GWG的有效性。我们将114名妊娠7 - 21周（14.9 ± 2.6）的肥胖妇女（BMI [平均值± SD] 36.7 ± 4.9 kg/m2）随机分为干预组（n = 56）和常规护理对照组（n = 58）。干预措施包括个性化的卡路里目标，建议将体重保持在随机化的3%以内，并遵循无钠限制的饮食方法来阻止高血压饮食模式，并参加每周一次的小组会议，直到分娩。对照组参与者接受一次性饮食建议。我们的三个主要结果是从随机化到产后2周和从随机化到妊娠34周的母亲体重变化，以及新生儿大于胎龄（出生体重>第90百分位数，LGA）。干预参与者从随机化到妊娠34周体重增加较少（5.0 vs 8.4 kg，平均差异= − 3.4 kg，95% CI [− 5.1，− 1.8]），从随机化到产后2周体重增加较少（− 2.6 vs +1.2 kg，平均差异= − 3.8 kg，95% CI [− 5.9，− 1.7]）。他们的LGA婴儿比例也较低（9% vs. 26%，比值比= 0.28，95% CI [0.09，0.84]）。干预导致GWG和LGA新生儿患病率降低。
Observational studies suggest that minimal gestational weight gain (GWG) may optimize pregnancy outcomes for obese women. This trial tested the efficacy of a group-based weight management intervention for limiting GWG among obese women. We randomized 114 obese women (BMI [mean±SD] 36.7±4.9 kg/m2) between 7–21 weeks’ (14.9±2.6) gestation to intervention (n=56) or usual care control conditions (n=58). The intervention included individualized calorie goals, advice to maintain weight within 3% of randomization and follow the Dietary Approaches to Stop Hypertension dietary pattern without sodium restriction, and attendance at weekly group meetings until delivery. Control participants received one-time dietary advice. Our three main outcomes were maternal weight change from randomization to 2 weeks postpartum and from randomization to 34 weeks gestation, and newborn large-for-gestational age (birth weight >90th percentile, LGA). Intervention participants gained less weight from randomization to 34 weeks gestation (5.0 vs 8.4 kg, mean difference=−3.4 kg, 95% CI [−5.1, −1.8]), and from randomization to 2 weeks postpartum (−2.6 vs +1.2 kg, mean difference=−3.8 kg, 95% CI [−5.9, −1.7]). They also had a lower proportion of LGA babies (9% vs. 26%, odds ratio=0.28, 95% CI [0.09, 0.84]). The intervention resulted in lower GWG and lower prevalence of LGA newborns.
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