Perinatal Outcomes in Nutritionally Monitored Obese Pregnant Women: A Randomized Clinical Trial
Perinatal Outcomes in Nutritionally Monitored Obese Pregnant Women: A Randomized Clinical Trial
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DOI：
10.1016/s0027-9684(15)30942-1
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发表时间：
2009-06-01
影响因子：
3.3
通讯作者：
Ishoof, Sabriya B.
中科院分区：
文献类型：
--
作者：
Thornton, Yvonne S.;Smarkola, Claudia;Ishoof, Sabriya B.
工作背景：虽然肥胖在怀孕期间继续与正在进行的健康问题，许多临床医生一直不愿意把非糖尿病，肥胖，孕妇对监测，热量适当的营养方案，担心胎儿生长受限，低出生体重，或饥饿ketosis.Methods：共有257例患者参加了随机研究，失访率为9.73%。患者被随机分配到对照组（n = 116），包括常规的产前饮食管理，或研究（监测）组（n = 116），其中规定了均衡的营养方案，并要求在日记中记录每天吃的所有食物。如果孕妇在妊娠12 - 28周之间怀了一个胎儿，并且孕前体重指数超过30 kg/m2，则有资格参加这项研究。主要结局是比较对照组与研究组的围产期结局。结果：综合MANOVA显示研究组和对照组在3个变量上存在统计学显著差异：（1）妊娠期高血压，p <0.46;（2）母亲分娩前最后一次体重，p <0.001;（3）母亲产后6周体重，p <0.001。患者在怀孕期间获得15磅或更多的8个variables.Conclusion组之间的统计学显着差异：肥胖的孕妇可能会被放置在一个健康的，平衡良好的，监测营养计划在其产前过程中没有不良的围产期结局。（Clinicaltrials.gov标识符：NCT 00740766）
Background: Although obesity in pregnancy continues to be associated with ongoing health problems, many clinicians have been reluctant to place nondiabetic, obese, pregnant women on a monitored, calorie-appropriate nutritional regimen for fear of fetal growth restriction, low birth weight, or starvation ketosis.Methods: A total of 257 patients were enrolled in the randomized study, with a loss-to-follow-up rate of 9.73%. Patients were assigned randomly to either the control (unmonitored) group (n = 116), consisting of conventional prenatal dietary management, or to the study (monitored) group (n = 116), which was prescribed a balanced nutritional regimen and were asked to record in a diary all of the foods eaten during each day. Women were eligible for the study if they were pregnant with a single fetus between 12 and 28 weeks of gestation and had a prepregnancy body mass index of more than 30 kg/m(2). The primary outcome was to compare perinatal outcomes in the control vs the study groups. The secondary measure was to compare outcomes in adherent and nonadherent patients in the study group.Results: Omnibus MANOVA showed statistically significant differences between the study and control groups regarding 3 variables: (1) gestational hypertension, p < .46; (2) mother's last weight before delivery, p < .001; and (3) mother's 6-week postpartum weight, p < .001. Patients gaining 15 pounds or more during their pregnancy showed statistically significant differences between the groups for 8 variables.Conclusion: Obese pregnant women may be placed on a healthy, well-balanced, monitored nutritional program during their antepartum course without adverse perinatal outcomes. (Clinicaltrials.gov identifier: NCT00740766)