The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women
The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women
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DOI：
10.1016/j.ajog.2013.09.029
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发表时间：
2014-02-01
影响因子：
9.8
通讯作者：
Secher, Niels J.
中科院分区：
文献类型：
--
作者：
Renault, Kristina M.;Norgaard, Kirsten;Secher, Niels J.
目的：本研究的目的是通过与对照组比较，评估有或没有饮食干预的肥胖孕妇的妊娠期体重增加（GWG）的计步器评估的身体活动干预。研究设计：本研究是一项随机对照试验，425名肥胖孕妇比较3组：（1）PA + D，身体活动和饮食干预（n = 142）;（2）PA，体力活动干预组（n = 142）;（3）C，接受标准护理的对照组（n = 141）。所有参与者在妊娠11-14周常规进行初始饮食咨询，并建议将GWG限制在5 kg以下。体力活动干预包括鼓励增加体力活动，目标是每天步数为11，000步，每4周连续7天通过计步器评估进行监测。饮食干预包括低热量地中海式饮食的随访。每2周由营养师进行指导。主要结局指标为GWG，次要结局指标为妊娠和分娩并发症及新生儿结局。结果：389例患者（92%）完成了研究。与对照组（10.9 [-4.4至28.7] kg [PA+D vs C]; P = 0.01; PA vs C; P = 0.042）相比，每个干预组（PA + D，8.6 [-9.6至34.1] kg，PA组，9.4 [-3.4至28.2] kg）的GWG（范围）中位数均较低。两个干预组之间无显著差异。在多变量分析中，体力活动干预使GWG平均降低1.38 kg（P = .040）。医学研究所的建议GWG更频繁地遵循在干预groups.CONCLUSION：体力活动干预评估计步器与或不与饮食后续减少GWG与对照组相比，肥胖孕妇。
OBJECTIVE: The objective of the study was to assess physical activity intervention assessed by a pedometer with or without dietary intervention on gestational weight gain (GWG) in obese pregnant women by comparing with a control group.STUDY DESIGN: This study was a randomized controlled trial of 425 obese pregnant women comparing 3 groups: (1) PA plus D, physical activity and dietary intervention (n = 142); (2) PA, physical activity intervention (n = 142); and (3) C, a control group receiving standard care (n = 141). All participants routinely in gestational weeks 11-14 had an initial dietary counseling session and were advised to limit GWG to less than 5 kg. Physical activity intervention included encouragement to increase physical activity, aiming at a daily step count of 11,000, monitored by pedometer assessment on 7 consecutive days every 4 weeks. Dietary intervention included follow-up on a hypocaloric Mediterranean-style diet. Instruction was given by a dietician every 2 weeks. The primary outcome measure was GWG, and the secondary outcome measures were complications of pregnancy and delivery and neonatal outcome.RESULTS: The study was completed by 389 patients (92%). Median values of GWG(ranges) were lower in each of the intervention groups (PA plus D, 8.6 [-9.6 to 34.1] kg, and group PA, 9.4 [-3.4 to 28.2] kg) compared with the control group (10.9 [-4.4 to 28.7] kg [PA+D vs C]; P = .01; PA vs C; P = .042). No significant difference was found between the 2 intervention groups. In a multivariate analysis, physical activity intervention decreased GWG by a mean of 1.38 kg (P = .040). The Institute of Medicine's recommendations for GWG were more frequently followed in the intervention groups.CONCLUSION: Physical activity intervention assessed by pedometer with or without dietary follow-up reduced GWG compared with controls in obese pregnant women.