Lee Amelia, Karpavicius Jane, Gasparini Elisabeth, Forster Della
Nutrition Department, Royal Women's Hospital, Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2012 Oct;52(5):427-32. doi: 10.1111/j.1479-828X.2012.01436.x. Epub 2012 Apr 17.
Thirty-four per cent of Australian women having a baby are overweight or obese. Excessive gestational weight gain leads to significant complications for mother and baby, not only during the pregnancy but in the long term. Limiting weight gain in pregnancy is thought to reduce complications, but there is limited evidence to guide practice.
To test the feasibility and acceptance of an intervention aimed at limiting gestational weight gain in obese pregnant women.
A low-cost multidisciplinary program, comprised of four individual dietary education sessions and three exercise classes, was developed and implemented at a tertiary hospital in metropolitan Melbourne, Australia. The Maternal Weight Management program was offered to obese women at their pregnancy booking visit. Program uptake and women's views of the program were explored via telephone survey, and pregnancy and birth outcomes collected.
Seventy-four women participated in this pilot study; 95% attended at least one session of the program and the attrition rates were high. Fifty-three per cent completed the postnatal survey. Women confirmed their preference for individual appointments and felt it was important for the hospital to offer a weight management program.
The program we designed had poor uptake and cannot be recommended in its current format. Future studies and considerations could look at more acceptable program design and recruitment strategies and should include formative work with women who would be eligible for such intervention.
在澳大利亚,34% 的产妇超重或肥胖。孕期体重过度增加不仅在孕期会给母婴带来严重并发症,长期来看也会产生不良影响。人们认为限制孕期体重增加可减少并发症,但目前指导实践的证据有限。
测试一项旨在限制肥胖孕妇孕期体重增加的干预措施的可行性和可接受性。
在澳大利亚墨尔本市区的一家三级医院制定并实施了一个低成本的多学科项目,该项目包括四次个人饮食教育课程和三次健身课程。“孕产妇体重管理项目”在肥胖女性孕期预约就诊时提供。通过电话调查了解项目参与情况以及女性对该项目的看法,并收集妊娠和分娩结局数据。
74 名女性参与了这项试点研究;95% 的人至少参加了该项目的一次课程,且流失率很高。53% 的人完成了产后调查。女性确认她们更倾向于单独预约,并认为医院提供体重管理项目很重要。
我们设计的项目参与度不佳,目前形式不可取。未来的研究和思考可以着眼于设计更易被接受的项目和招募策略,并且应该包括与符合此类干预条件的女性开展形成性研究。