Relationship of Loss of Control Eating to Excessive Gestational Weight Gain

描述(由申请人提供)：超过45%的女性超过医学研究所(IOM)制定的妊娠期体重增加(GWG)指南。开始怀孕、超重或肥胖的女性比正常体重的女性更有可能超过国际移民组织的指导方针。过量(GWG)与负面产科结局有关，增加后代肥胖的风险，并导致更大的产后体重滞留。预防过多的GWG可以改善产科结果，并可能导致改善妇女肥胖的治疗。然而，预防全球变暖过多的干预措施并不总是成功的，需要确定与全球变暖相关的可改变行为，以支持制定有效的干预措施，以防止全球变暖。对进食失去控制(LOC)，或摄入食物，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。LOC还与抑郁症状和心理社会困扰有关，这也与体重增加有关。因此，拟议研究的目标是评估GWG、LOC和心理社会苦恼之间的关系。怀孕前超重或肥胖的孕妇(N=300)将从当地妇女医院的产科诊所招募。妇女将完成结构化的临床访谈，包括进食障碍检查(EDE)和DSM-IV诊断的结构化临床访谈(SCID)，以记录怀孕前三个月结束时的LOC和抑郁症状。感知压力、社会支持、卡路里摄入量、体力活动和其他与GWG相关的因素的测量也将在妊娠早期收集。在怀孕20至36周期间，每月将通过电话重复对LOC、心理社会困扰、饮食和活动的评估。为了记录产后体重滞留，女性将在产后6个月再次接受采访。体重将在每次面对面访问时进行评估，并在怀孕结束时从妇女的医疗表中提取GWG。拟议的研究是调查小组先前工作的延伸，将提供关于全球变暖过多的可修改机制的重要数据。了解GWG过多的行为机制可能有助于采取干预措施，防止GWG过多，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.