Kinnunen Tarja I, Pasanen Matti, Aittasalo Minna, Fogelholm Mikael, Weiderpass Elisabete, Luoto Riitta
UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland.
Nutr J. 2007 Sep 10;6:21. doi: 10.1186/1475-2891-6-21.
Postpartum weight retention may contribute to the development of obesity. We studied whether individual counselling on diet and physical activity from 2 to 10 months postpartum has positive effects on diet and leisure time physical activity and increases the proportion of primiparas returning to their pre-pregnancy weight.
A controlled trial including ninety-two postpartum primiparas was conducted in three intervention and three control child health clinics in primary health care in Finland. The intervention included individual counselling on diet and physical activity during five routine visits to a public health nurse; the controls received the usual care.
In total, 50% of the intervention group and 30% of the control group returned to their pre-pregnancy weight (weight retention <or= 0 kg) by 10 months postpartum (p = 0.06). The confounder-adjusted odds ratio for returning to pre-pregnancy weight was 3.89 (95% CI 1.16-13.04, p = 0.028) for the intervention group compared with the controls. The mean proportion of high-fibre bread (of total weekly amount of bread) increased by 16.1% (95% CI 4.3-27.9) by 10 months postpartum in the intervention group compared with the controls when adjusted for confounders (p = 0.008). No significant differences were observed in changes in leisure time physical activity between the groups.
The intervention increased the proportion of primiparas returning to pre-pregnancy weight and the proportion of high-fibre bread in their diet. Larger randomized controlled trials are needed to show whether counselling can improve dietary and leisure time physical activity habits in postpartum women and also to confirm the results concerning the effect on reducing postpartum weight retention.
产后体重滞留可能会导致肥胖的发生。我们研究了产后2至10个月进行的关于饮食和体育活动的个体化咨询是否对饮食和休闲时间的体育活动有积极影响，以及是否能增加初产妇恢复到孕前体重的比例。
在芬兰初级卫生保健的三个干预性儿童健康诊所和三个对照性儿童健康诊所中，对92名产后初产妇进行了一项对照试验。干预措施包括在五次定期拜访公共卫生护士期间进行关于饮食和体育活动的个体化咨询；对照组接受常规护理。
到产后10个月时，干预组中有50%的产妇恢复到了孕前体重（体重滞留≤0千克），而对照组中这一比例为30%（p = 0.06）。与对照组相比，干预组恢复到孕前体重的混杂因素调整优势比为3.89（95%可信区间1.16 - 13.04，p = 0.028）。在对混杂因素进行调整后，干预组产后10个月时高纤维面包（占每周面包总量的比例）的平均比例比对照组增加了16.1%（95%可信区间4.3 - 27.9）（p = 0.008）。两组在休闲时间体育活动的变化方面未观察到显著差异。
该干预措施提高了初产妇恢复到孕前体重的比例以及她们饮食中高纤维面包的比例。需要更大规模的随机对照试验来表明咨询是否能改善产后女性的饮食和休闲时间体育活动习惯，同时也需要证实关于减少产后体重滞留效果的研究结果。
