Martin Julia, MacDonald-Wicks Lesley, Hure Alexis, Smith Roger, Collins Clare E
School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Newcastle 2308, New South Wales, Australia.
School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Newcastle 2308, New South Wales, Australia.
Nutrients. 2015 Feb 25;7(3):1464-79. doi: 10.3390/nu7031464.
Overweight and obesity is prevalent among women of reproductive age (42% BMI > 25 kg/m2) and parity is associated with risk of weight gain. Weight gain greater than that recommended by the Institute of Medicine (IOM )is also associated with lower rates of breastfeeding initiation and duration in women. The aim of this pilot randomised controlled trial is to examine the feasibility of recruiting and maintaining a cohort of pregnant women with the view of reducing postpartum weight retention and improving breastfeeding outcomes. Women (BMI of 25-35 kg/m2 (n = 36)) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Participants were stratified by BMI and randomised to one of three groups with follow-up to six months postpartum. Women received a dietary intervention with or without breastfeeding support from a lactation consultant, or were assigned to a wait-list control group where the dietary intervention was issued at three months postpartum. Feasibility and acceptability was assessed by participation rates and questionnaire. Analysis of variance and covariance was conducted to determine any differences between groups. Sixty-nine per cent of the participants were still enrolled at six months postpartum. This pilot demonstrated some difficulties in recruiting women from antenatal clinics and retaining them in the trial. Although underpowered; the results on weight; biomarkers and breastfeeding outcomes indicated improved metabolic health.
超重和肥胖在育龄妇女中很普遍（42%的体重指数>25kg/m²），产次与体重增加风险相关。超过医学研究所（IOM）建议的体重增加也与女性较低的母乳喂养启动率和持续时间相关。这项初步随机对照试验的目的是研究招募和维持一组孕妇的可行性，以期减少产后体重滞留并改善母乳喂养结果。从澳大利亚新南威尔士州约翰·亨特医院产前诊所招募了女性（体重指数为25 - 35kg/m²（n = 36））。参与者按体重指数分层，随机分为三组之一，随访至产后六个月。女性接受有或没有哺乳顾问母乳喂养支持的饮食干预，或被分配到等待名单对照组，在产后三个月进行饮食干预。通过参与率和问卷调查评估可行性和可接受性。进行方差分析和协方差分析以确定组间的任何差异。69%的参与者在产后六个月仍在参与研究。这项初步试验表明，从产前诊所招募女性并让她们留在试验中有一些困难。尽管样本量不足，但关于体重、生物标志物和母乳喂养结果的结果表明代谢健康有所改善。
