Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: the Fit for Delivery Study
Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: the Fit for Delivery Study
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DOI：
10.3945/ajcn.110.005306
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发表时间：
2011-04-01
影响因子：
7.1
通讯作者：
Wing, Rena R.
中科院分区：
文献类型：
--
作者：
Phelan, Suzanne;Phipps, Maureen G.;Wing, Rena R.
背景资料：怀孕期间体重过度增加是产后体重保持和女性未来体重增加和肥胖的主要危险因素，但很少有足够的动力随机对照试验研究怀孕期间行为体重控制干预的有效性。目的：本研究旨在探讨怀孕期间的行为干预是否可以降低超过1990年医学研究所（IOM）的女性比例。妊娠期体重增加的建议，并增加产后6个月恢复到妊娠前体重的妇女比例。设计：本研究是一项随机、评估者盲法、对照试验。研究对象为妊娠期（13.5周）、正常体重（NW; n = 201）和超重或肥胖（OW/OB; n = 200）的女性，平均年龄为28.8岁。参与者被随机分配到1990年IOM体重类别（NW与OW/OB相比）的标准护理（n = 200）或行为干预，以防止过度妊娠体重增加（n = 201）。干预措施包括一次面对面的访问;每周邮寄材料，促进适当的体重增加，健康饮食和锻炼;体重增加的个人图表;和电话反馈。结果：意向治疗分析显示，与标准护理相比，干预措施降低了超过IOM建议的NW妇女的百分比（40.2%比52.1%; P = 0.003），并增加了产后6个月恢复到妊娠前体重或以下的NW和OW/OB妇女的百分比结论：妊娠期低强度行为干预可降低NW妇女妊娠期体重增加，预防NW和OW/OB妇女产后体重保持。该试验在clinicaltrials.gov上注册为NCT 01117961。美国临床营养杂志2011;93：772-9。
Background: Excessive weight gain during pregnancy is a major risk factor for postpartum weight retention and future weight gain and obesity in women, but few adequately powered randomized controlled trials have examined the efficacy of a behavioral weight-control intervention during pregnancy.Objective: This study examined whether a behavioral intervention during pregnancy could decrease the proportion of women who exceeded the 1990 Institute of Medicine (IOM) recommendations for gestational weight gains and increase the proportion of women who returned to pregravid weights by 6 mo postpartum.Design: This study was a randomized, assessor-blind, controlled trial. Participants were pregnant (13.5 wk gestation), normal-weight (NW; n = 201) and overweight or obese (OW/OB; n = 200) women whose average age was 28.8 y. Participants were randomly assigned within the 1990 IOM weight category (NW compared with OW/OB) to standard care (n = 200) or to a behavioral intervention to prevent excessive gestational weight gain (n = 201). The intervention included one face-to-face visit; weekly mailed materials that promoted an appropriate weight gain, healthy eating, and exercise; individual graphs of weight gain; and telephone-based feedback. The retention at the 6-mo postpartum assessment was 82%.Results: Intent-to-treat analyses showed that the intervention, compared with standard care, decreased the percentage of NW women who exceeded IOM recommendations (40.2% compared with 52.1%; P = 0.003) and increased the percentages of NW and OW/OB women who returned to their pregravid weights or below by 6 mo postpartum (30.7% compared with 18.7%; P = 0.005).Conclusion: A low-intensity behavioral intervention during pregnancy reduced excessive gestational weight gains in NW women and prevented postpartum weight retention in NW and OW/OB women. This trial was registered at clinicaltrials.gov as NCT01117961. Am J Clin Nutr 2011;93:772-9.