Expecting Success: Personalized management of body weight during pregnancy

描述（由申请人提供）：怀孕期间体重增加过多会导致母亲及其后代出现显著的长期代谢疾病。在美国，超过50%的育龄妇女在怀孕期间的体重增加超过了医学研究所建议的指导方针。以健康饮食和规律体育活动为目标的生活方式改变项目在控制体重增加和预防其他高危人群肥胖相关的合并症方面取得了成功。然而，很少有生活方式干预研究在孕妇中进行，以控制妊娠期体重增加，没有一个成功地帮助妇女坚持指导方针。虽然孕妇被认为是一个积极接受行为改变的人群，但她们面临着传统的面对面诊所体重管理计划的几个障碍。我们通过远程保健技术（智能手机）成功实施了生活方式干预措施，对超重和肥胖者进行体重管理，这些措施很容易适用于孕妇。因此，将远程保健技术应用于孕妇可以成功地解决这些障碍，并有助于在怀孕期间适当增加体重。本研究“期望成功：孕期个性化体重管理”的目的是为超重和肥胖孕妇实施个性化的孕期体重管理计划，重点关注健康饮食和实现国家体育活动建议。300名初产超重和肥胖妇女将被随机分配接受常规护理或个性化的生活方式计划，以管理体重，亲自或通过智能手机远程提供。生活方式项目包括从怀孕第13周到分娩期间每周与咨询师联系。临床评估将在整个怀孕期间以及产后第一年对母亲和子女进行。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一个主要健康问题。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。

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.