Adiposity and cardiovascular outcomes in three-year-old children of participants inUPBEAT, anRCTof a complex intervention in pregnant women with obesity
Adiposity and cardiovascular outcomes in three-year-old children of participants inUPBEAT, anRCTof a complex intervention in pregnant women with obesity
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DOI：
10.1111/ijpo.12725
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发表时间：
2020-09-11
影响因子：
3.8
通讯作者：
Poston, Lucilla
中科院分区：
文献类型：
--
作者：
Dalrymple, Kathryn V.;Tydeman, Florence A. S.;Poston, Lucilla
背景母亲肥胖与后代心脏代谢风险相关。UPBEAT是一项在1555名肥胖妇女中进行的产前饮食和体力活动干预的随机对照试验。干预与妊娠期体重增加减少、更健康的饮食和妊娠期代谢特征以及6个月时婴儿肥胖减少有关。目的：我们调查了UPBEAT干预是否影响儿童心脏代谢结果，或与分娩后3年母亲生活方式的持续改善有关。方法在UPBEAT母子配对中，在3年的随访中，我们评估了儿童期血压、静息脉率和肥胖（体重指数、皮褶厚度、体脂、腰围和臂围）以及母亲的饮食、体力活动和人体测量。结果514名3岁儿童参加了预约（49%干预，51%标准护理）。两个试验组的主要关注结局肩胛下皮褶厚度无差异（-0.30 mm，95%置信区间：-0.92，0.31）。然而，干预与较低的静息脉率相关（-5 bpm [-8.41，-1.07]）。超重/肥胖的几率也没有显著降低（OR 0.73; 0.50，1.08）。在UPBEAT试验中观察到的母亲饮食改善，包括贫血负荷和饱和脂肪，在产后3年内保持不变。结论本研究表明，产前饮食和体力活动干预肥胖妇女与较低的后代脉搏率和母亲饮食的持续改善。虽然大于先前的队列，但仍有可能存在来自损耗的偏倚，这些结果需要在未来的队列中进行验证。
Background Maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months. Objective We have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery. Methods In UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry. Results 514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30 mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5 bpm [-8.41, -1.07]). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum. Conclusion This study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.