Antenatal dietary and lifestyle advice for women who are overweight or obese and the effect on fetal growth and adiposity: the LIMIT randomised trial.
Antenatal dietary and lifestyle advice for women who are overweight or obese and the effect on fetal growth and adiposity: the LIMIT randomised trial.
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DOI：
10.1111/1471-0528.13777
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Dodd JM
中科院分区：
文献类型：
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作者：
Grivell RM;Yelland LN;Deussen A;Crowther CA;Dodd JM
报告母体超重和肥胖对胎儿生长和肥胖的影响，以及这些妇女产前饮食和生活方式干预对胎儿生长和肥胖指标的影响，作为LIMIT试验的次要结局。随机对照试验。南澳大都市阿德莱德的公立妇产医院。BMI ≥ 25 kg/m2且单胎妊娠在10+0-20+0周之间的孕妇。妇女被随机分配到生活方式建议或继续标准护理，并在妊娠28周和36周提供两次研究超声扫描。超声测量胎儿生长和肥胖。对于每个胎仔身体成分参数，平均Z评分与人群标准相比显著更高。与接受标准治疗的女性胎儿相比，接受生活方式建议的女性胎儿的平均大腿中部脂肪量显著更大（平均值校正差异为0.17; 95%置信区间（CI）为0.02至0.32; p=0.0245）。虽然两个治疗组胎仔的肩胛下脂肪量在妊娠28 - 36周之间增加，但与接受标准治疗的女性胎仔相比，接受生活方式建议的女性胎仔的脂肪组织沉积速率减慢（p=0.0160）。未观察到其他显著差异。这些发现提供了第一个证据，表明超重或肥胖妇女在产前饮食和生活方式干预后胎儿生长发生了变化。
To report the influence of maternal overweight and obesity on fetal growth and adiposity and effects of an antenatal dietary and lifestyle intervention among these women on measures of fetal growth and adiposity as secondary outcomes of the LIMIT Trial. Randomised controlled trial. Public maternity hospitals in metropolitan Adelaide, South Australia. Pregnant women with a BMI ≥25kg/m2, and singleton gestation between 10+0–20+0 weeks. Women were randomised to Lifestyle Advice or continued Standard Care and offered two research ultrasound scans at 28 and 36 weeks gestation. Ultrasound measures of fetal growth and adiposity. For each fetal body composition parameter, mean Z-scores were substantially higher when compared with population standards. Fetuses of women receiving Lifestyle Advice demonstrated significantly greater mean mid thigh fat mass, when compared with fetuses of women receiving Standard Care (Adjusted Difference in Means 0.17; 95% Confidence Intervals (CI) 0.02 to 0.32; p=0.0245). While subscapular fat mass increased between 28 and 36 weeks gestation in fetuses in both treatment groups, the rate of adipose tissue deposition slowed among fetuses of women receiving Lifestyle Advice, when compared with fetuses of women receiving Standard Care (p=0.0160). No other significant differences were observed. These findings provide the first evidence of changes to fetal growth following an antenatal dietary and lifestyle intervention among women who are overweight or obese.