Lifestyle Interventions in Overweight and Obese Pregnant Women

超重和肥胖孕妇的生活方式干预

• 批准号: 9330401
• 负责人: DYMPNA GALLAGHER
• 金额: $ 19.98万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-19 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9330401
• 关键词: Accelerometer; Adipose tissue; Adult; Age; Anthropometry; Behavior; Behavioral; Biological Process; Birth; Blood; Body Weight; CCL2 gene; Catchment Area; Child; Cost Analysis; Counseling; Data; Dietary intake; Dropout; Enrollment; Environment; Fatty acid glycerol esters; Funding; Future; Generations; Glucose; Guidelines; High Density Lipoprotein Cholesterol; Hospitals; Infant; Inflammatory; Institute of Medicine (U.S.); Insulin; Internet; Intervention; Intramuscular; Knowledge; Lead; Leptin; Life; Lipids; Magnetic Resonance Imaging; Measurement; Measures; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Participant; Physical activity; Physicians; Plasma; Plasminogen Activator Inhibitor 1; Postpartum Period; Pregnancy; Pregnant Women; Prevalence; Preventive Intervention; Professional counselor; Public Health; Quality of life; Questionnaires; Randomized Controlled Trials; Recommendation; Risk; Risk Factors; Secondary to; Socioeconomic Status; Telephone; Visceral; Visit; Weight; Weight Gain; Whole Body Plethysmography; Woman; adiponectin; arm; cardiometabolic risk; cohort; cost effective; ethnic diversity; gestational weight gain; group counseling; improved; in utero; infant monitoring; inflammatory marker; lifestyle intervention; low density lipoprotein triglyceride; nutrition; offspring; pregnant; prevent; primary outcome; racial diversity; reproductive; subcutaneous; treatment as usual

DESCRIPTION (provided by applicant): A randomized controlled trial is proposed to study the effect, in a cohort of racially and ethnically diverse group of overweight and obese pregnant women, of an Intensive Lifestyle Intervention (ILI) compared to Usual Care (UC) on gestational weight gain (GWG), infant fatness, and mothers' post-delivery weight retention. Women in the ILI arm will receive intensive counseling during pregnancy and group counseling after delivery regarding behavior, nutrition, and physical activity change. Visits to counselors will be weekly and additional telephone and internet contacts will occur. The mothers' will be assessed at 14 and 36 weeks of pregnancy and at 12 weeks and 52 weeks post-delivery. The measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (BodPod). The infants' measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (PeaPod) for fatness 12 weeks and 52 weeks. Mothers and children will have cardio-metabolic risk factors measured in plasma. Data will be collected regarding mothers' dietary intake and physical activity (questionnaires and accelerometry) to assist in counseling. Other data to be collected include questionnaires on quality of life, socio-economic status. Careful record will be kept of expenses in providing the ILI, so that cost analysis of the intervention can be calculated. The study is powered on the primary outcome, fatness of the infants at birth. We require 180 participants to attain appropriate power. We will enroll 210 so as to allow for some dropouts along the way. Each mother will be followed during pregnancy and for a year post delivery. Each infant will be followed for a year after birth. We have the ability o continue to follow these participants if further funding is forthcoming, as they are all local to or hospital's catchment area and our own physicians. If aims are achieved, namely that both children and mothers profit from the intervention, there should be a paradigm shift in how overweight pregnant women are treated. At present, there is a dearth of behavioral advice and intervention relating to GWG and physical activity provided to these women. Positive results from our study would provide evidence for ILI preventative intervention.

描述（由申请人提供）：拟开展一项随机对照试验，以研究在不同种族和民族的超重和肥胖孕妇群体中，强化生活方式干预（ILI）与常规护理（UC）相比对妊娠期体重增加（GWG）、婴儿肥胖和母亲产后体重保持的影响。 ILI 组的女性将在怀孕期间接受强化咨询，并在分娩后接受有关行为、营养和身体活动变化的团体咨询。每周都会拜访辅导员，并会进行额外的电话和互联网联系。母亲将在怀孕 14 周和 36 周以及产后 12 周和 52 周时接受评估。测量将包括人体测量学、全身 MRI、EchoMRI 和全身体积描记法 (BodPod)。对婴儿 12 周和 52 周的肥胖情况进行人体测量、全身 MRI、EchoMRI 和全身体积描记法 (PeaPod) 测量。母亲和儿童将在血浆中测量心脏代谢危险因素。将收集有关母亲饮食摄入量和身体活动的数据（问卷和加速度测量）以协助咨询。其他要收集的数据包括有关生活质量、社会经济状况的调查问卷。将仔细记录提供 ILI 的费用，以便计算干预的成本分析。该研究的主要结果是婴儿出生时的肥胖程度。我们需要 180 名参与者才能获得适当的权力。我们将报名 210 人，以便 允许沿途出现一些中途退出的情况。每位母亲在怀孕期间和产后一年内都会受到跟踪。每个婴儿出生后将被跟踪一年。如果有进一步的资金支持，我们有能力继续跟踪这些参与者，因为他们都是本地人或医院的服务区域以及我们自己的医生。如果目标得以实现，即儿童和母亲都从干预中受益，那么超重孕妇的治疗方式应该发生范式转变。目前，缺乏向这些女性提供的与 GWG 和身体活动相关的行为建议和干预措施。 我们研究的积极结果将为流感样疾病预防干预提供证据。