O'Brien O A, McCarthy M, Gibney E R, McAuliffe F M
UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
Food Business and Development, University College Cork, Cork, Ireland.
Eur J Clin Nutr. 2014 Jul;68(7):760-6. doi: 10.1038/ejcn.2014.59. Epub 2014 Apr 30.
Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.
超重和肥胖与孕产妇和胎儿不良结局风险增加相关。然而，临床实践中提供有效的生活方式干预措施面临资源需求高的阻碍。探索利用技术辅助生活方式干预作为减轻资源压力、提高干预效果及扩大干预覆盖人群的有效方法。目的是系统回顾关于技术支持的生活方式干预对健康孕妇的应用及其对孕产妇结局影响的文献。2013年3月检索了在线数据库和登记处。所选英文研究的主要结局指标为孕妇空腹血糖、妊娠期糖尿病（GDM）发病率及孕妇孕期体重增加。次要结局指标为干预措施的采用和接受情况，以及饮食或身体活动的改变。干预前被诊断为GDM的研究对象的研究被排除。符合条件的研究数量极少且结局各异，因此无法对数据进行正式的荟萃分析。最初，共识别并筛选出203篇文章。七篇文章，包括五项随机对照试验，符合本次综述的纳入标准。结果表明，尽管检索结果有限，但技术支持的孕期干预措施有诸多潜在益处。虽然通信技术有望成为支持孕期生活方式干预的安全治疗工具，但其有效性的数据却很匮乏。需要进一步开展随机对照试验来检验通信技术的有效性，尤其是在那些最有可能从生活方式干预中获益的人群中，如超重和肥胖的孕妇。
