Department of Obstetrics and Gynaecology, The Academic Medical Centre, Amsterdam, The Netherlands.
Department of Public and Occupational Health and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
Am J Perinatol. 2014 May;31(5):353-64. doi: 10.1055/s-0033-1352484. Epub 2013 Aug 5.
Lifestyle interventions in obese pregnant women reduce adverse maternal outcomes of pregnancy. However, the association between weight change due to interventions and the actual reduction in complications is unknown. The objective of this study was to determine the association between gestational weight gain (GWG) and the rate of pregnancy complications.
The authors included randomized controlled trials (RCTs) assessing the effect of lifestyle interventions during pregnancy on GWG and adverse maternal and fetal outcomes. For each outcome they assessed the association between GWG and the risk of adverse pregnancy outcomes.
They analyzed data of 23 RCTs (4,990 women). Increased GWG was associated with a nonsignificant increase in the incidence of preeclampsia (PE) (0.2% per gained kg, 95% confidence interval [CI] 0.5 to 0.9%, p > 0.05), gestational diabetes (GDM) (0.3% per gained kg, 95% CI -0.5 to 1.0%, p > 0.05), and induction of labor (IOL) (1.5% per gained kg, 95% CI -0.9 to 3.9%, p > 0.05).
Reduction in GWG due to lifestyle interventions in pregnancy had statistically nonsignificant effects on lowering the incidence of PE, GDM, and IOL. Possibly, the beneficial effect of lifestyle interventions on pregnancy outcomes is due to an effect independent of the reduction of GWG.
生活方式干预可减少肥胖孕妇的妊娠不良结局。然而,干预导致的体重变化与并发症实际减少之间的关联尚不清楚。本研究旨在确定妊娠体重增加(GWG)与妊娠并发症发生率之间的关系。
作者纳入了评估生活方式干预对妊娠 GWG 和母婴不良结局影响的随机对照试验(RCT)。对于每种结局,作者评估了 GWG 与不良妊娠结局风险之间的关系。
作者分析了 23 项 RCT(4990 名女性)的数据。GWG 增加与子痫前期(PE)发生率的非显著增加相关(每增加 1kg 体重增加 0.2%,95%置信区间[CI]为 0.5 至 0.9%,p>0.05)、妊娠糖尿病(GDM)(每增加 1kg 体重增加 0.3%,95%CI 为-0.5 至 1.0%,p>0.05)和引产(IOL)(每增加 1kg 体重增加 1.5%,95%CI 为-0.9 至 3.9%,p>0.05)。
妊娠期间生活方式干预导致的 GWG 减少对降低 PE、GDM 和 IOL 的发生率具有统计学上无显著意义的影响。可能,生活方式干预对妊娠结局的有益影响是独立于 GWG 减少之外的。