Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial.
Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial.
复制标题
DOI：
10.1136/bmj.g1285
复制
发表时间：
2014-02-10
期刊：
影响因子：
--
通讯作者：
LIMIT Randomised Trial Group
中科院分区：
文献类型：
--
作者：
Dodd JM;Turnbull D;McPhee AJ;Deussen AR;Grivell RM;Yelland LN;Crowther CA;Wittert G;Owens JA;Robinson JS;LIMIT Randomised Trial Group
目的探讨产前饮食和生活方式干预对超重和肥胖孕妇健康结局的影响。设计多中心随机试验。我们使用了一个中央电话随机服务器，它具有计算机生成的时间表、平衡的可变区组以及对产次、体重指数(BMI)类别和医院的分层。在南澳大利亚州设立三家公立妇产科医院。研究对象2212名单胎妊娠妇女，孕周在10+0到20+0之间，体重指数≥为25。干预1108名妇女随机接受由研究人员提供的全面饮食和生活方式干预；1104名妇女随机接受标准护理，并根据当地指南接受妊娠护理，该指南不包括此类信息。主要观察指标出生时胎龄较大的婴儿的发生率(出生体重、孕期和性别的≥第90厘米)。预先确定的次要结局包括出生体重和体重4000克、高血压、先兆子痫和妊娠期糖尿病。分析使用意向治疗的原则。结果2152名妇女和2142名活产婴儿进入分析。两组婴儿胎龄过大的危险性差异无统计学意义(生活方式建议203/1075(19%)vs标准护理224/1067(21%)；调整后相对危险度0.90，95%可信区间0.77~1.07；P=0.24)。生活方式建议后，女性所生婴儿出生体重超过4000克的可能性显著降低(生活方式建议164/1075(15%)对标准护理201/1067(19%)；0.82，0.68至0.99；需要治疗的数量(NNT)28，15至263；P=0.04)。两个治疗组在产妇妊娠和分娩结局方面没有差异。结论对于超重或肥胖的女性，这项研究中使用的产前生活方式建议并不能降低分娩体重超过孕龄和性别的第90厘米的风险，也不能改善母亲的怀孕和分娩结果。澳大利亚和新西兰临床试验注册(ACTRN12607000161426)。
Objective To determine the effect of antenatal dietary and lifestyle interventions on health outcomes in overweight and obese pregnant women. Design Multicentre randomised trial. We utilised a central telephone randomisation server, with computer generated schedule, balanced variable blocks, and stratification for parity, body mass index (BMI) category, and hospital. Setting Three public maternity hospitals across South Australia. Participants 2212 women with a singleton pregnancy, between 10+0 and 20+0 weeks’ gestation, and BMI ≥25. Interventions 1108 women were randomised to a comprehensive dietary and lifestyle intervention delivered by research staff; 1104 were randomised to standard care and received pregnancy care according to local guidelines, which did not include such information. Main outcome measures Incidence of infants born large for gestational age (birth weight ≥90th centile for gestation and sex). Prespecified secondary outcomes included birth weight >4000 g, hypertension, pre-eclampsia, and gestational diabetes. Analyses used intention to treat principles. Results 2152 women and 2142 liveborn infants were included in the analyses. The risk of the infant being large for gestational age was not significantly different in the two groups (lifestyle advice 203/1075 (19%) v standard care 224/1067 (21%); adjusted relative risk 0.90, 95% confidence interval 0.77 to 1.07; P=0.24). Infants born to women after lifestyle advice were significantly less likely to have birth weight above 4000 g (lifestyle advice 164/1075 (15%) v standard care 201/1067 (19%); 0.82, 0.68 to 0.99; number needed to treat (NNT) 28, 15 to 263; P=0.04). There were no differences in maternal pregnancy and birth outcomes between the two treatment groups. Conclusions For women who were overweight or obese, the antenatal lifestyle advice used in this study did not reduce the risk delivering a baby weighing above the 90th centile for gestational age and sex or improve maternal pregnancy and birth outcomes. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
登录
查看更多内容
影响因子：
8
作者：
Boney, CM;Verma, A;Vohr, BR
通讯作者：
Vohr, BR
影响因子：
7.2
作者：
Cedergren, Marie I.
通讯作者：
Cedergren, Marie I.
影响因子：
2.6
作者：
Abenhaim, Haim A.;Kinch, Robert A.;Usher, Robert
通讯作者：
Usher, Robert
DOI：
10.1111/j.1479-828x.2012.01425.x
发表时间：
2012-06-01
影响因子：
1.7
作者：
Dodd, Jodie M.;Catcheside, Britt;Scheil, Wendy
通讯作者：
Scheil, Wendy
影响因子：
11.4
作者：
Callaway, LK;Prins, JB;McIntyre, HD
通讯作者：
McIntyre, HD