Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial
Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial
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DOI：
10.1038/ijo.2012.162
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发表时间：
2013-06-01
影响因子：
4.9
通讯作者：
van den Bergh, B. R. H.
中科院分区：
文献类型：
--
作者：
Bogaerts, A. F. L.;Devlieger, R.;van den Bergh, B. R. H.
目的：生活方式干预可以帮助肥胖孕妇在怀孕期间限制体重增加并改善其心理舒适度，但尚未在随机对照试验中进行评估。我们评估是否有针对性的产前生活方式干预计划肥胖孕妇影响妊娠期体重增加（GWG）和焦虑或抑郁mood.Design和受试者的水平：本研究采用了纵向干预设计。在235名符合条件的肥胖孕妇中，（平均年龄（岁）：29 +/- 4.5;体重指数（BMI，kg m（-2））：34.7 ± 4.6）被随机分配到对照组，一个小册子组接受健康生活方式的书面信息，一个实验组接受额外的四次产前生活方式干预会议，由一名受过动机训练的助产士进行。生活方式干预焦虑（状态和特质焦虑量表）和抑郁的感觉（爱丁堡抑郁量表）在怀孕的第一，第二和第三个三个月进行了测量。社会人口，行为，心理和医疗变量用于控制和纠正outcome variables.RESULTS：我们发现一个显着减少GWG的小册子（9.5公斤）和生活方式干预（10.6公斤）组与正常护理组（13.5公斤）相比（P = 0.007）。此外，焦虑水平显着下降的生活方式干预组和增加在正常护理组在怀孕期间（P = 0.02），没有差异，在宣传册组。孕前BMI与焦虑水平呈正相关。最近戒烟的肥胖孕妇表现出显着较高的GWG（β = 3.04; P = 0.01）;那些并发妊娠糖尿病（GDM）（β = 3.54; P = 0.03）和那些经常饮酒的人（β = 3.69; P = 0.04）表现出显着较高的状态焦虑水平。抑郁情绪或产科/新生儿的结果之间没有显着差异观察three groups.Conclusions：有针对性的生活方式干预计划的基础上的原则，动机访谈减少GWG和肥胖孕妇的焦虑水平。
OBJECTIVE: Lifestyle intervention could help obese pregnant women to limit their weight gain during pregnancy and improve their psychological comfort, but has not yet been evaluated in randomized controlled trials. We evaluated whether a targeted antenatal lifestyle intervention programme for obese pregnant women influences gestational weight gain (GWG) and levels of anxiety or depressed mood.DESIGN AND SUBJECTS: This study used a longitudinal interventional design. Of the 235 eligible obese pregnant women, 205 (mean age (years): 29 +/- 4.5; body mass index (BMI, kg m(-2)): 34.7 +/- 4.6) were randomized to a control group, a brochure group receiving written information on healthy lifestyle and an experimental group receiving an additional four antenatal lifestyle intervention sessions by a midwife trained in motivational lifestyle intervention. Anxiety (State and Trait Anxiety Inventory) and feelings of depression (Edinburgh Depression Scale) were measured during the first, second and third trimesters of pregnancy. Socio-demographical, behavioural, psychological and medical variables were used for controlling and correcting outcome variables.RESULTS: We found a significant reduction of GWG in the brochure (9.5 kg) and lifestyle intervention (10.6 kg) group compared with normal care group (13.5 kg) (P = 0.007). Furthermore, levels of anxiety significantly decreased in the lifestyle intervention group and increased in the normal care group during pregnancy (P = 0.02); no differences were demonstrated in the brochure group. Pre-pregnancy BMI was positively related to levels of anxiety. Obese pregnant women who stopped smoking recently showed a significant higher GWG (beta = 3.04; P = 0.01); those with concurrent gestational diabetes mellitus (GDM) (beta = 3.54; P = 0.03) and those who consumed alcohol on a regular base (beta = 3.69; P = 0.04) showed significant higher levels of state anxiety. No differences in depressed mood or obstetrical/neonatal outcomes were observed between the three groups.CONCLUSIONS: A targeted lifestyle intervention programme based on the principles of motivational interviewing reduces GWG and levels of anxiety in obese pregnant women.