Relationship of Loss of Control Eating to Excessive Gestational Weight Gain

描述（由申请人提供）：超过45%的妇女超过了医学研究所（IOM）制定的妊娠期体重增加（GWG）指南。开始怀孕时超重或肥胖的妇女比正常体重的妇女更有可能超过IOM指南。过量（GWG）与不良产科结局有关，增加了后代肥胖的风险，并导致产后体重保持更大。防止过度GWG可以改善产科结局，并可能导致改善妇女肥胖症的治疗。然而，干预措施，以防止过度GWG并不总是成功的，有必要确定与GWG相关的可修改的行为，以支持开发有效的干预措施，以防止过度GWG。进食失控（英语：Loss of control over eating），或食物的摄入加上无法控制进食量的感觉，与体重增加密切相关，并且是可以改变的。抑郁症也与抑郁症状和心理困扰有关，这些症状和心理困扰也与体重增加有关。因此，拟议的研究的目标是评估GWG，抑郁和心理社会困扰之间的关系。 怀孕前超重或肥胖的孕妇（N = 300）（即，怀孕前BMI>25）将从当地妇女医院的产科诊所招募。女性将完成结构化的临床访谈，包括饮食失调检查（EDE）和DSM- IV诊断的结构化临床访谈（SCID），以记录妊娠前三个月结束时的焦虑和抑郁症状。在孕早期还将收集感知压力、社会支持、卡路里摄入、体力活动和其他与GWG相关的因素的测量结果。在妊娠第20周至第36周期间，每月通过电话重复评估焦虑、心理社会困扰、饮食和活动。为了记录产后体重保持情况，妇女将在产后6个月再次接受采访。将在每次亲自访视时评估体重，并在妊娠结束时从女性病历中提取GWG。 拟议的研究是调查小组以前工作的延伸，并将提供关于过量GWG的可修改机制的重要数据。了解过度GWG的行为机制可能会为预防过度GWG的干预措施提供信息，从而改善母亲和儿童的健康。

DESCRIPTION (provided by applicant): More than 45% of women exceed guidelines established by the Institute of Medicine (IOM) for gestational weight gain (GWG). Women who begin pregnancy overweight or obese are more likely to exceed the IOM guidelines than are normal weight women. Excessive (GWG) is associated with negative obstetric outcomes, increases the risk of obesity in offspring and leads to greater postpartum weight retention. Preventing excessive GWG can improve obstetric outcomes and may lead to improvements in the treatment of obesity for women. However, interventions to prevent excessive GWG have not been consistently successful, and there is a need to identify modifiable behaviors related to GWG to support the development of effective interventions to prevent excessive GWG. Loss of control over eating (LOC), or the ingestion of food coupled with a sense of being unable to control the quantity eaten, is strongly associated with weight gain and is modifiable. LOC also is related to depressive symptoms and psychosocial distress which also are associated with weight gain. Thus, the goal of the proposed study is to assess relationships among GWG, LOC and psychosocial distress. Pregnant women (N = 300) who are overweight or obese prior to pregnancy (i.e., pregravid BMI>25) will be recruited from obstetric clinics at a local women's hospital. Women will complete structured, clinical interviews including the Eating Disorder Examination (EDE) and the Structured Clinical Interview for DSM- IV diagnoses (SCID) to document LOC and depressive symptoms at the end of the first trimester of pregnancy. Measures of perceived stress, social support, calorie intake, physical activity, and other factors related to GWG also will collected in first trimester. Assessments of LOC, psychosocial distress, eating and activity will be repeated monthly by telephone between weeks 20 and 36 of pregnancy. To document postpartum weight retention, women will be interviewed again at 6 months postpartum. Weight will be assessed at each in person visit and GWG abstracted from women's medical charts at the end of pregnancy. The proposed research is an extension of previous work conducted by the investigative team, and will provide important data on modifiable mechanisms for excessive GWG. Understanding behavioral mechanisms of excessive GWG is likely to inform interventions to prevent excessive GWG and thereby improve the health of mothers and children.