Preventing Excessive Weight Gain During Pregnancy Through Dietary and Lifestyle Counseling A Randomized Controlled Trial
Preventing Excessive Weight Gain During Pregnancy Through Dietary and Lifestyle Counseling A Randomized Controlled Trial
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DOI：
10.1097/aog.0b013e318195baef
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发表时间：
2009-02-01
影响因子：
7.2
通讯作者：
Rutledge, Allyson
中科院分区：
文献类型：
--
作者：
Asbee, Shelly M.;Jenkins, Todd R.;Rutledge, Allyson
目的：评估一个有组织的、一致的饮食和生活方式咨询项目是否能防止孕期体重过度增加。方法：这项随机对照试验将妇女分配接受有组织的、一致的强化饮食和生活方式咨询计划或常规产前护理。主要研究结果是妊娠期体重增加在医学研究所（IOM）指南范围内的患者比例。次要结局包括分娩方式、手术阴道分娩率、新生儿体重、先兆子痫、妊娠糖尿病（GDM）、阴道/会阴撕裂伤和肩部难产的发生率。结果：共有100名妇女被随机纳入研究（生活方式咨询57名，常规产前护理43名）。各研究组的基线人口统计学特征相似。生活方式咨询组的体重增加明显少于常规产前护理组（28.7 +/- 12.5磅比35.6 +/- 5.5磅，P= 0.01）。常规产前护理组因“进展失败”导致的剖宫产发生率明显高于常规产前护理组（58.3%，生活方式咨询组25.0%，P= 0.02）。在所有组中，未遵守IOM指南的患者的新生儿明显更重(坚持3,203.2 +/- 427.2 g与未坚持3,517.4 +/- 572.4 g相比，P
OBJECTIVE: To estimate whether an organized, consistent program of dietary and lifestyle counseling prevents excessive weight gain in pregnancy.METHODS: This randomized controlled trial assigned women to receive either an organized, consistent program of intensive dietary and lifestyle counseling or routine prenatal care. The primary study outcome was the proportion of patients whose gestational weight gain was within the Institute of Medicine (IOM) guidelines. Secondary outcomes included mode of delivery, rate of operative vaginal delivery, neonatal weight, and the incidence of preeclampsia, gestational diabetes mellitus (GDM), vaginal/perineal lacerations, and shoulder dystocia.RESULTS: A total of 100 women were randomized to the study (lifestyle counseling 57, routine prenatal care 43). Baseline demographic characteristics were similar between the study groups. The lifestyle counseling group gained significantly less weight than did the routine prenatal care group (28.7 +/- 12.5 lb compared with 35.6 +/- 5.5 lb, P=.01). The routine prenatal care group had significantly more cesarean deliveries due to "failure to progress" (routine prenatal care 58.3% compared with lifestyle counseling 25.0%, P=.02). Across groups, patients who were not adherent to the IOM guidelines had significantly heavier neonates (adherent 3,203.2 +/- 427.2 g compared with not adherent 3,517.4 +/- 572.4 g, P