Kramer M S
McGill University, Faculty of Medicine, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2.
Cochrane Database Syst Rev. 2007 Jul 18(4):CD000149. doi: 10.1002/14651858.CD000149.
Background pending.
To assess the effects of advising pregnant women to increase their energy and protein intakes on those intakes, on gestational weight gain, and on the outcome of pregnancy.
The register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group. Date of last search: October 2001.
All acceptably controlled comparisons of nutritional advice, whether administered on a one-to-one basis or to groups of women.
Data were extracted by the author from published reports, and supplemented by additional information from trialists contacted by the author.
Four trials involving 1108 women were included. Advice to increase energy and protein intakes seems to be successful in achieving those goals, but the increases are lower than those reported in trials of actual protein/energy supplementation. Data concerning effects on pregnancy outcome are available only from one trial, and, given the fact that its analysis was based on individual women despite randomization by clinic, the calculated confidence intervals are undoubtedly too narrow. Moreover, the 'significant' reduction in preterm birth associated with advice is not consistent with the total absence of effect on mean gestational age. One trial found no reduction in the incidence of pre-eclampsia. No data have been reported on potential adverse effects that might accompany increased fetal size, such as an increased risk of prolonged labour or Caesarean section.
AUTHORS' CONCLUSIONS: Nutritional advice appears effective in increasing pregnant women's energy and protein intakes, but the implications for fetal, infant, or maternal health cannot be judged from the available trials. Given the rather modest health benefits demonstrated with actual protein/energy supplementation (see the Cochrane review of 'Balanced protein/energy supplementation in pregnancy'), however, the provision of such advice is unlikely to be of major importance.
背景待定。
评估建议孕妇增加能量和蛋白质摄入量对这些摄入量、孕期体重增加及妊娠结局的影响。
由Cochrane妊娠与分娩小组维护和更新的临床试验注册库。末次检索日期：2001年10月。
所有关于营养建议的可接受对照比较，无论建议是一对一提供还是针对女性群体。
作者从已发表的报告中提取数据，并通过与作者联系的试验者提供的额外信息进行补充。
纳入了四项涉及1108名女性的试验。增加能量和蛋白质摄入量的建议似乎能成功实现这些目标，但增加量低于实际蛋白质/能量补充试验中报告的增加量。关于对妊娠结局影响的数据仅来自一项试验，鉴于其分析是基于个体女性，尽管按诊所进行了随机分组，但计算出的置信区间无疑过窄。此外，与建议相关的早产“显著”减少与对平均孕周完全没有影响不一致。一项试验发现子痫前期发病率没有降低。未报告关于胎儿体型增大可能伴随的潜在不良影响的数据，如产程延长或剖宫产风险增加。
营养建议似乎能有效增加孕妇的能量和蛋白质摄入量，但从现有试验无法判断对胎儿、婴儿或母亲健康的影响。然而，鉴于实际蛋白质/能量补充所显示的健康益处相当有限（见Cochrane关于“孕期均衡蛋白质/能量补充”的综述），提供此类建议不太可能具有重要意义。
