Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Am J Obstet Gynecol. 2014 Feb;210(2):134.e1-9. doi: 10.1016/j.ajog.2013.09.029. Epub 2013 Sep 20.
The objective of the study was to assess physical activity intervention assessed by a pedometer with or without dietary intervention on gestational weight gain (GWG) in obese pregnant women by comparing with a control group.
This study was a randomized controlled trial of 425 obese pregnant women comparing 3 groups: (1) PA plus D, physical activity and dietary intervention (n = 142); (2) PA, physical activity intervention (n = 142); and (3) C, a control group receiving standard care (n = 141). All participants routinely in gestational weeks 11-14 had an initial dietary counseling session and were advised to limit GWG to less than 5 kg. Physical activity intervention included encouragement to increase physical activity, aiming at a daily step count of 11,000, monitored by pedometer assessment on 7 consecutive days every 4 weeks. Dietary intervention included follow-up on a hypocaloric Mediterranean-style diet. Instruction was given by a dietician every 2 weeks. The primary outcome measure was GWG, and the secondary outcome measures were complications of pregnancy and delivery and neonatal outcome.
The study was completed by 389 patients (92%). Median values of GWG (ranges) were lower in each of the intervention groups (PA plus D, 8.6 [-9.6 to 34.1] kg, and group PA, 9.4 [-3.4 to 28.2] kg) compared with the control group (10.9 [-4.4 to 28.7] kg [PA+D vs C]; P = .01; PA vs C; P = .042). No significant difference was found between the 2 intervention groups. In a multivariate analysis, physical activity intervention decreased GWG by a mean of 1.38 kg (P = .040). The Institute of Medicine's recommendations for GWG were more frequently followed in the intervention groups.
Physical activity intervention assessed by pedometer with or without dietary follow-up reduced GWG compared with controls in obese pregnant women.
本研究旨在评估通过计步器评估的体力活动干预措施，以及是否结合饮食干预，对肥胖孕妇的妊娠体重增加（GWG）的影响，与对照组进行比较。
这是一项比较 3 组肥胖孕妇的随机对照试验：（1）PA+D 组，体力活动和饮食干预（n=142）；（2）PA 组，体力活动干预（n=142）；（3）C 组，对照组，接受标准护理（n=141）。所有参与者在妊娠 11-14 周时常规进行初始饮食咨询，并建议将 GWG 限制在 5 公斤以内。体力活动干预包括鼓励增加体力活动，目标是每天计步 11000 步，每 4 周通过计步器评估连续 7 天监测。饮食干预包括随访低热量的地中海式饮食。营养师每两周进行一次指导。主要结局测量指标是 GWG，次要结局测量指标是妊娠和分娩并发症以及新生儿结局。
共有 389 名患者（92%）完成了研究。每个干预组（PA+D 组，8.6[9.6 至 34.1]公斤；PA 组，9.4[3.4 至 28.2]公斤）的 GWG 中位数（范围）均低于对照组（10.9[4.4 至 28.7]公斤[PA+D 与 C 相比，P=0.01；PA 与 C 相比，P=0.042）。两个干预组之间没有发现显著差异。在多变量分析中，体力活动干预使 GWG 平均减少 1.38 公斤（P=0.040）。在干预组中，《美国医学研究所》（Institute of Medicine）对 GWG 的建议更频繁地得到遵循。
与对照组相比，通过计步器评估的体力活动干预措施，以及是否结合饮食随访，可减少肥胖孕妇的 GWG。
