Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence.
Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence.
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DOI：
10.1136/bmj.e2088
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发表时间：
2012-05-16
期刊：
影响因子：
--
通讯作者：
Khan KS
中科院分区：
文献类型：
--
作者：
Thangaratinam S;Rogozinska E;Jolly K;Glinkowski S;Roseboom T;Tomlinson JW;Kunz R;Mol BW;Coomarasamy A;Khan KS
目的评价妊娠期饮食和生活方式干预对母儿体重的影响，并量化这些干预对产科结局的影响。设计系统综述和荟萃分析。数据来源主要数据库，从成立到2012年1月，没有语言限制。研究选择随机对照试验，评估任何饮食或生活方式干预可能影响妊娠期间母体体重和妊娠结局。数据综合结果总结为二分数据的相对风险和连续数据的平均差异。结果：我们确定了44项相关的随机对照试验（7278名妇女），评估了三类干预措施：饮食，体力活动和混合方法。总体而言，与对照组相比，任何干预措施均使妊娠期体重增加减少1.42 kg（95%置信区间为0.95至1.89 kg）。所有干预措施相结合，出生体重没有显着差异（平均差-50 g，-100至0 g）和大于胎龄儿的发生率（相对风险0.85，0.66至1.09）或小于胎龄儿（1.00，0.78至1.28），尽管体力活动本身与出生体重减轻有关（平均差异为-60 g，-120至-10 g）。干预与先兆子痫（0.74，0.60至0.92）和肩难产（0.39，0.22至0.70）的风险降低相关，对其他至关重要的结局无显著影响。与其他干预措施相比，饮食干预导致母亲妊娠期体重增加减少最多（3.84 kg，2.45至5.22 kg），妊娠结局改善。对于重要结局，如先兆子痫、妊娠期糖尿病、妊娠期高血压和早产，总体证据评级为低至极低。 结论孕期饮食和生活方式干预可减少孕妇妊娠期体重增加，改善母婴结局。在这些干预措施中，以饮食为基础的干预措施最有效，并与减少产妇妊娠期体重增加和改善产科结局有关。
Objective To evaluate the effects of dietary and lifestyle interventions in pregnancy on maternal and fetal weight and to quantify the effects of these interventions on obstetric outcomes. Design Systematic review and meta-analysis. Data sources Major databases from inception to January 2012 without language restrictions. Study selection Randomised controlled trials that evaluated any dietary or lifestyle interventions with potential to influence maternal weight during pregnancy and outcomes of pregnancy. Data synthesis Results summarised as relative risks for dichotomous data and mean differences for continuous data. Results We identified 44 relevant randomised controlled trials (7278 women) evaluating three categories of interventions: diet, physical activity, and a mixed approach. Overall, there was 1.42 kg reduction (95% confidence interval 0.95 to 1.89 kg) in gestational weight gain with any intervention compared with control. With all interventions combined, there were no significant differences in birth weight (mean difference −50 g, −100 to 0 g) and the incidence of large for gestational age (relative risk 0.85, 0.66 to 1.09) or small for gestational age (1.00, 0.78 to 1.28) babies between the groups, though by itself physical activity was associated with reduced birth weight (mean difference −60 g, −120 to −10 g). Interventions were associated with a reduced the risk of pre-eclampsia (0.74, 0.60 to 0.92) and shoulder dystocia (0.39, 0.22 to 0.70), with no significant effect on other critically important outcomes. Dietary intervention resulted in the largest reduction in maternal gestational weight gain (3.84 kg, 2.45 to 5.22 kg), with improved pregnancy outcomes compared with other interventions. The overall evidence rating was low to very low for important outcomes such as pre-eclampsia, gestational diabetes, gestational hypertension, and preterm delivery. Conclusions Dietary and lifestyle interventions in pregnancy can reduce maternal gestational weight gain and improve outcomes for both mother and baby. Among the interventions, those based on diet are the most effective and are associated with reductions in maternal gestational weight gain and improved obstetric outcomes.
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DOI：
10.1016/s0002-8223(02)90225-7
发表时间：
2002-07-01
影响因子：
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作者：
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发表时间：
1990-12-01
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影响因子：
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作者：
Cavalcante SR;Cecatti JG;Pereira RI;Baciuk EP;Bernardo AL;Silveira C
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