Reducing Maternal Obesity and Diabetes Risks Prior to Conception with the National Diabetes Prevention Program.
Reducing Maternal Obesity and Diabetes Risks Prior to Conception with the National Diabetes Prevention Program.
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DOI：
10.1007/s10995-023-03624-5
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发表时间：
2023-07
影响因子：
2.3
通讯作者：
中科院分区：
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宫内暴露于母亲肥胖和高血糖极大地增加了后代的健康风险。需要可扩展的生活方式干预措施，以在怀孕前降低体重和血糖，但研究不足，特别是在母婴结局不良风险高得不成比例的多样化和低收入妇女中。这份报告的目的是提供国家糖尿病预防计划(NDPP)对不同低收入妇女及其子女母子结局影响的初步证据。从2013年到2019年，在安全网医疗系统中向1569名参与者提供了为期一年的NDPP。使用医疗记录，我们评估了在参加≥1个月后怀孕并分娩的40岁妇女(n=32)的结局，与最初有资格参加NDPP但因登记时怀孕而被排除在外的40年普通护理妇女组(n=26)进行了比较。这两组中的大多数女性都是拉丁裔，有医疗补助或没有保险，在基线水平上有肥胖。从基线到妊娠的体重指数变化的平均差值为−1.80±0.6 kg/m2(p=0.002)。与常规护理相比，Ndpp参与者在受孕期肥胖(56.7%比88.0%，p=0.011)和怀孕早期高血糖(4.0%比25.0%；p=0.020)的发生率更低。其他差异在统计上没有显著差异，但几乎所有结果都有利于NDPP。协变量调整后的结果是一致的，除了怀孕时肥胖频率的差异不再显著(p=0.132)。结果提供了初步证据表明，NDPP可能支持在不同的低收入妇女中降低围产期肥胖/糖尿病的风险。
Intrauterine exposure to maternal obesity and hyperglycemia greatly increases offspring health risks. Scalable lifestyle interventions to lower weight and glycemia prior to conception are needed, but have been understudied, especially in diverse and low-income women with disproportionately high risks of negative maternal-child outcomes. The objective of this report is to provide initial evidence of the National Diabetes Prevention Program’s (NDPP) effects on maternal-child outcomes in diverse, low-income women and their offspring. The yearlong NDPP was delivered in a safety net healthcare system to 1,569 participants from 2013 to 2019. Using medical records, we evaluated outcomes for women < 40 years who became pregnant and delivered after attending the NDPP for ≥ 1 month (n = 32), as compared to a usual care group of women < 40 years (n = 26) who were initially eligible for the NDPP but were excluded due to pregnancy at enrollment. Most women in either group were Latinx, had Medicaid or were uninsured, and had obesity at baseline. The mean difference in BMI change from baseline to conception was − 1.8 ± 0.6 kg/m2 (p = 0.002) for NDPP versus usual care. Fewer NDPP participants had obesity at conception (56.7% vs. 88.0%, p = 0.011) and hyperglycemia in early pregnancy (4.0% vs. 25.0%; p = 0.020) than usual care. No other differences were statistically significant, yet nearly all outcomes favored the NDPP. Covariate-adjusted results were consistent, except the difference in frequency of obesity at conception was no longer significant (p = 0.132). Results provide preliminary evidence that the NDPP may support a reduction in peri-conceptional obesity/diabetes risks among diverse and low-income women.
影响因子：
3.7
作者：
通讯作者：
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