The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial.
The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial.
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DOI：
10.1186/s12916-014-0163-9
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发表时间：
2014-10-13
期刊：
影响因子：
9.3
通讯作者：
LIMIT Randomised Trial Group
中科院分区：
文献类型：
--
作者：
Dodd JM;McPhee AJ;Turnbull D;Yelland LN;Deussen AR;Grivell RM;Crowther CA;Wittert G;Owens JA;Robinson JS;LIMIT Randomised Trial Group
怀孕期间超重和肥胖是一个相当大的健康负担。虽然研究集中在限制妊娠期体重增加的干预措施上，但很少有信息描述它们对新生儿健康的影响。我们的目的是调查为超重或肥胖的妇女提供产前饮食和生活方式建议对一系列预先规定的次级新生儿结局的影响。我们报告了一系列预先指定的次级新生儿结局，这些结局来自一项大型随机试验，该试验向超重或肥胖的妇女提供产前饮食和生活方式建议。体重指数≥ 25 kg/m2且单胎妊娠在10+0和20+0周之间的孕妇有资格参与研究。结果指标包括出生时胎龄; 5分钟时Apgar评分低于7;出生时需要复苏;出生体重高于4.5 kg或低于2.5 kg;出生体重、身长和头围（和Z评分）;进入托儿所;呼吸窘迫综合征;和产后住院时间。与主要结局（大于胎龄儿定义为出生体重高于第90百分位数）和出生体重高于4 kg相关的数据先前已报告。分析采用意向治疗原则。共有2，142名婴儿被纳入分析。遵循生活方式建议的妇女所生的婴儿出生体重超过4.5公斤的可能性显着降低（2.15% vs 3.69%;校正风险比（aRR）= 0.59; 95%置信区间（CI）0.36 - 0.98; P = 0.04），或呼吸窘迫综合征（1.22% vs 2.57%; aRR = 0.47; 95%CI 0.24 - 0.90; P = 0.02），尤其是中度或重度疾病，且产后住院时间较短（3.94 ± 7.26天vs 4.41 ± 9.87天;校正均值比0.89; 95% CI 0.82 - 0.97; P = 0.006）。对于超重或肥胖的妇女，产前饮食和生活方式建议对婴儿的健康有益，而不会增加伤害的风险。对儿童期的持续随访对于评估降低高婴儿出生体重对儿童肥胖风险的长期影响至关重要。请参阅相关文章：http://www.biomedcentral.com/1741-7015/12/161和http://www.biomedcentral.com/1741-7015/12/201。澳大利亚和新西兰临床试验注册中心（ACTRN 12607000161426）
Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese. We report a range of pre-specified secondary neonatal outcomes from a large randomised trial in which antenatal dietary and lifestyle advice was provided to women who were overweight or obese. Pregnant women were eligible for participation with a body mass index of 25 kg/m2 or over, and singleton gestation between 10+0 and 20+0 weeks. Outcome measures included gestational age at birth; Apgar score below 7 at 5 minutes of age; need for resuscitation at birth; birth weight above 4.5 kg or below 2.5 kg; birth weight, length and head circumference (and Z-scores); admission to the nursery; respiratory distress syndrome; and postnatal length of stay. Data relating to the primary outcome (large for gestational age infants defined as birth weight above the 90th centile) and birth weight above 4 kg have been reported previously. Analyses used intention-to-treat principles. In total, 2,142 infants were included in the analyses. Infants born to women following lifestyle advice were significantly less likely to have birth weight above 4.5 kg (2.15% versus 3.69%; adjusted risk ratio (aRR) = 0.59; 95% confidence interval (CI) 0.36 to 0.98; P = 0.04), or respiratory distress syndrome (1.22% versus 2.57%; aRR = 0.47; 95% CI 0.24 to 0.90; P = 0.02), particularly moderate or severe disease, and had a shorter length of postnatal hospital stay (3.94 ± 7.26 days versus 4.41 ± 9.87 days; adjusted ratio of means 0.89; 95% CI 0.82 to 0.97; P = 0.006) compared with infants born to women who received Standard Care. For women who are overweight or obese, antenatal dietary and lifestyle advice has health benefits for infants, without an increase in the risk of harm. Continued follow-up into childhood will be important to assess the longer-term effects of a reduction in high infant birth weight on risk of child obesity. Please see related articles: http://www.biomedcentral.com/1741-7015/12/161 and http://www.biomedcentral.com/1741-7015/12/201. Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426)
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DOI：
10.1056/nejmoa1309753
发表时间：
2014-01-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cunningham SA;Kramer MR;Narayan KM
通讯作者：
Narayan KM
影响因子：
3.4
作者：
Au, Nicole
通讯作者：
Au, Nicole
影响因子：
7.2
作者：
Cedergren, Marie I.
通讯作者：
Cedergren, Marie I.
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