Expecting Success: Personalized management of body weight during pregnancy

描述（由申请人提供）：妊娠期间体重过度增加导致母亲及其后代显著的长期代谢性疾病。美国超过50%的育龄妇女在怀孕期间体重增加超过医学研究所建议的指南。针对健康饮食和定期体育活动的生活方式改变计划成功地控制了体重增加，并预防了其他高危人群中与肥胖相关的合并症。然而，很少有生活方式干预研究在孕妇中进行，以管理妊娠期体重增加，没有一个成功地帮助妇女遵守指南。虽然孕妇被认为是一个高度积极的人口接受行为改变，他们面临着传统的人在诊所体重管理计划的几个障碍。我们已成功地通过远程保健技术（智能手机）对超重和肥胖者实施了体重管理的生活方式干预措施，这些措施很容易适应孕妇。因此，将远程保健技术应用于孕妇可能会成功地消除这些障碍，并促进怀孕期间适当增加体重。这项研究的目的是“期待成功：怀孕期间的个性化体重管理”，旨在对超重和肥胖的孕妇实施个性化的妊娠期体重管理计划，重点是健康饮食和实现国家体育活动建议。300名超重和肥胖的产妇将被随机分配接受常规护理或个性化的生活方式计划，亲自或通过智能手机远程提供体重管理。生活方式计划包括从怀孕13周到分娩每周与顾问接触。将在整个妊娠期以及产后第一年内对母体和后代进行临床评估。这项研究意义重大，因为它旨在防止怀孕期间体重过度增加，这是孕妇及其后代的主要健康问题。如果成功，我们的智能手机方法将为孕妇的体重管理提供一种新颖，有效和可扩展的干预措施。 公共卫生相关性：迄今为止，管理超重和肥胖孕妇妊娠期体重增加的努力尚未成功。作为对2009年lOM修订报告的回应，NIH正在赞助超重和肥胖孕妇的生活方式研究，以促进怀孕期间适当的体重增加，并调查妊娠体重增加对母亲及其后代健康指标的影响。

DESCRIPTION (provided by applicant): Excess weight gain during pregnancy leads to significant long-term metabolic morbidities in mothers and their offspring. More than 50% of reproductive age women in the US exceed weight gain guidelines during pregnancy as recommended by the Institute of Medicine. Lifestyle modification programs targeting healthy eating and regular physical activity are successful in controlling weight gain as well as preventing obesity related co-morbidities in other at risk populations. However few lifestyle intervention studies have been conducted in pregnant women to manage gestational weight gain and none were successful in helping women adhere to the guidelines. Although pregnant women are believed to be a highly motivated population for accepting behavior change, they face several barriers to traditional in-person clinic weight management programs. We have successfully implemented lifestyle interventions for weight management through Tele-health technologies (Smartphone) to overweight and obese individuals and these are readily adaptable to pregnant women. Application of Tele-health technologies to pregnant women may therefore successfully address these barriers and facilitate appropriate weight gain during pregnancy. The objective of this study "Expecting Success: Personalized weight management during pregnancy" is to implement a personalized gestational weight management program to overweight and obese pregnant women that focuses on healthy eating and achieving National physical activity recommendations. 300 primiparous overweight and obese women will be randomly assigned to receive either usual care or a personalized lifestyle program for weight management delivered in-person or remotely via a Smartphone. The lifestyle program involves weekly contact with counselors from week 13 of gestation until delivery. Clinical assessments will be obtained throughout pregnancy and in the mother and offspring during the first year postpartum. This study is significant because it seeks to prevent excess weight gain during pregnancy, a major health problem for pregnant women and their offspring. If successful, our Smartphone approach will provide a novel, efficacious and scalable intervention for weight management in pregnant women. PUBLIC HEALTH RELEVANCE: Efforts to manage gestational weight gain in overweight and obese pregnant women have not been successful to date. In response a revised report from the lOM in 2009, the NIH is sponsoring lifestyle studies in overweight and obese pregnant women to promote appropriate weight gain during pregnancy and to investigate the effect of gestational weight gain on health indicators in mothers and their offspring.