Weight Management in Obese Pregnant Underserved African American Women

母亲肥胖和不适当的妊娠期体重增加（GWG）增加了母亲和新生儿 发病率和死亡率。此外，肥胖女性的后代患神经发育障碍的风险增加。 延迟，变得肥胖，并发展成代谢性疾病。在社会经济方面 弱势群体（SED），特别是非洲裔美国人（AA），特别容易受到 由于肥胖症的高发病率，这些国家的妇女在怀孕后会出现不良后果。因此，我们认为， 妊娠期间成功的体重管理在SED，AA妇女有相当大的公共卫生 影响我们在SED非妊娠女性中测试生活方式干预方面有经验， 在社区组织内实施和维持，如家长作为教师（PAT）， 国家家访计划，为高需求者免费提供亲子教育和服务。 在幼儿园之前，每年对妇女进行多达25次的产前和产后家访。 我们建议进行一项为期24个月（产前6个月和产后18个月）的随机对照研究， 在肥胖SED AA女性中进行的试验，以评估创新生活方式干预计划（PAT-i-）的能力， 在产前和产后家访期间，由PAT家长教育工作者提供，以改善孕产妇和 新生儿/婴儿体重、代谢和健康结果。广泛的方案评估将确定 通过衡量方案范围，确定PAT+干预措施在真实的世界环境中的适用性， 可接受性、可持续性。如果有效，PAT+可以通过这个国家传播， 该组织目前有超过249 000名母亲和319 000名儿童参加了2 173个PAT 在全国50个州。

Maternal obesity and inappropriate gestational weight gain (GWG) increase both maternal and neonatal morbidity and mortality. In addition, offspring of obese women are at increased risk for neurodevelopmental delay, becoming obese, and developing metabolic diseases. Women who are socio-economically disadvantaged (SED), especially from African American (AA) populations, are particularly susceptible to adverse pregnancy-related outcomes because of their high prevalence rates of obesity. Therefore, successful weight management during pregnancy in SED, AA women has considerable public health implications. We have experience in testing lifestyle interventions among SED nonpregnant women that have been implemented and sustained within community organizations such as Parents As Teachers (PAT), a national home visiting program that provides parent-child education and services free-of-charge to high-needs women, prenatally and post-partum, through up to 25 home visits per year until kindergarten. We propose to conduct a 24-month (6-month prenatal and 18-month post-partum) randomized, controlled trial in obese SED AA women to evaluate the ability of an innovative lifestyle intervention program (PAT-i-), delivered by PAT parent educators during prenatal and post-partum home visits, to improve maternal and neonatal/infant weight, metabolic and health outcomes. An extensive programmatic evaluation will determine the applicability of the PAT+ intervention in real world settings by measuring programmatic reach, implementation, acceptability, and sustainability. If effective, PAT+ can be disseminated through this national organization, which currently reaches over 249,000 mothers and 319,000 children participating in 2,173 PAT programs across all 50 states.