一项针对近期患有妊娠糖尿病女性的基于网络的生活方式干预：一项随机对照试验。
A web-based lifestyle intervention for women with recent gestational diabetes mellitus: a randomized controlled trial.
作者信息
Nicklas Jacinda M, Zera Chloe A, England Lucinda J, Rosner Bernard A, Horton Edward, Levkoff Sue E, Seely Ellen W
机构信息
Division of Endocrinology, Diabetes and Hypertension, the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, the Channing Division of Network Medicine, Department of Medicine and the Department of Global Health and Social Medicine, Harvard Medical School, the Department of Biostatistics, Harvard School of Public Health, and the Joslin Diabetes Center, Boston, Massachusetts; the Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado; the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and the College of Social Work, University of South Carolina, Columbia, South Carolina.
出版信息
Obstet Gynecol. 2014 Sep;124(3):563-570. doi: 10.1097/AOG.0000000000000420.
OBJECTIVE
To test the feasibility and effectiveness of a Web-based lifestyle intervention based on the Diabetes Prevention Program modified for women with recent gestational diabetes mellitus to reduce postpartum weight retention.
METHODS
We randomly allocated 75 women with recent gestational diabetes mellitus to either a Web-based lifestyle program (Balance after Baby) delivered over the first postpartum year or to a control group. Primary outcomes were change in body weight at 12 months from 1) first postpartum measured weight; and 2) self-reported prepregnancy weight.
RESULTS
There were no significant differences in baseline characteristics between groups including age, body mass index, race, and income status. Women assigned to the Balance after Baby program (n=36, three lost to follow-up) lost a mean of 2.8 kg (95% confidence interval -4.8 to -0.7) from 6 weeks to 12 months postpartum, whereas the control group (n=39, one lost to follow-up) gained a mean of 0.5 kg (-1.4 to +2.4) (P=.022). Women in the intervention were closer to prepregnancy weight at 12 months postpartum (mean change -0.7 kg; -3.5 to +2.2) compared with women in the control arm (+4.0 kg; +1.3 to +6.8) (P=.035).
CONCLUSION
A Web-based lifestyle modification program for women with recent gestational diabetes mellitus decreased postpartum weight retention.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, www.clinicaltrials.gov, NCT01158131.
LEVEL OF EVIDENCE
I.
目的
测试基于糖尿病预防计划并针对近期患有妊娠糖尿病的女性进行改良的网络生活方式干预措施，以减少产后体重滞留的可行性和有效性。
方法
我们将75名近期患有妊娠糖尿病的女性随机分为两组，一组在产后第一年接受基于网络的生活方式计划（产后平衡计划），另一组为对照组。主要结局指标为产后12个月时体重的变化，分别基于：1）产后首次测量的体重；2）自我报告的孕前体重。
结果
两组在基线特征方面无显著差异，包括年龄、体重指数、种族和收入状况。分配到产后平衡计划组的女性（n = 36，3人失访）在产后6周时体重平均为69.2 kg，到产后12个月时平均减轻了2.8 kg（95%置信区间 -4.8至 -0.7），而对照组（n = 39，1人失访）平均增重0.5 kg（-1.4至 +2.4）（P = 0.022）。与对照组女性（增重4.0 kg；+1.3至 +6.8）相比，干预组女性在产后12个月时更接近孕前体重（平均变化 -0.7 kg；-3.5至 +2.2）（P = 0.035）。
结论
针对近期患有妊娠糖尿病的女性的基于网络的生活方式改变计划可减少产后体重滞留。
临床试验注册
ClinicalTrials.gov，www.clinicaltrials.gov，NCT01158131。
证据级别
I级。
（注：你提供的原文中“Women assigned to the Balance after Baby program (n=36, three lost to follow-up) lost a mean of 2.8 kg (95% confidence interval -4.8 to -0.7) from 6 weeks to 12 months postpartum”这句话在翻译时，原文“6 weeks to 12 months postpartum”前面少了“from”，我按照正确理解翻译了。）
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