Opray Nicolle, Grivell Rosalie M, Deussen Andrea R, Dodd Jodie M
School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Women's and Children's Hospital, Level 1 QVB, 72 King William Street, Adelaide, South Australia, Australia, 5006.
Cochrane Database Syst Rev. 2015 Jul 14;2015(7):CD010932. doi: 10.1002/14651858.CD010932.pub2.
Overweight and obesity (body mass index (BMI) ≥ 25.0 to 29.9 kg/m(2) and BMI ≥ 30 kg/m(2,) respectively are increasingly common among women of reproductive age. Overweight and obesity are known to be associated with many adverse health conditions in the preconception period, during pregnancy and during the labour and postpartum period. There are no current guidelines to suggest which preconception health programs and interventions are of benefit to these women and their infants. It is important to evaluate the available evidence to establish which preconception interventions are of value to this population of women.
To evaluate the effectiveness of preconception health programs and interventions for improving pregnancy outcomes in overweight and obese women.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2014) and reference lists of retrieved studies.
Randomised controlled trials (including those using a cluster-randomised design), comparing health programs and interventions with routine care in women of reproductive age and a BMI greater then or equal to 25 kg/m(2). Studies published in abstract form only, were not eligible for inclusion. Quasi-randomised trials or randomised trials using a cross-over design were not eligible for inclusion in this review. The intervention in such studies would involve an assessment of preconception health and lead to an individualised preconception program addressing any areas of concern for that particular woman.Preconception interventions could involve any or all of: provision of specific information, screening for and treating obesity-related health problems, customised or general dietary and exercise advice, medical or surgical interventions. Medical interventions may include treatment of pre-existing hypertension, impaired glucose tolerance or sleep apnoea. Surgical interventions may include interventions such as bariatric surgery. The comparator was prespecified to be standard preconception advice or no advice/interventions.
We identified no studies that met the inclusion criteria for this review. The search identified one study (published in four trial reports) which was independently assessed by two review authors and subsequently excluded.
There are no included trials.
AUTHORS' CONCLUSIONS: We found no randomised controlled trials that assessed the effect of preconception health programs and interventions in overweight and obese women with the aim of improving pregnancy outcomes. Until the effectiveness of preconception health programs and interventions can be established, no practice recommendations can be made. Further research is required in this area.
超重和肥胖（体重指数（BMI）分别≥25.0至29.9kg/m²和BMI≥30kg/m²）在育龄妇女中越来越普遍。已知超重和肥胖在孕前、孕期以及分娩和产后期间与许多不良健康状况相关。目前尚无指南表明哪些孕前健康计划和干预措施对这些妇女及其婴儿有益。评估现有证据以确定哪些孕前干预措施对这一女性群体有价值很重要。
评估孕前健康计划和干预措施对改善超重和肥胖妇女妊娠结局的有效性。
我们检索了Cochrane妊娠与分娩小组试验注册库（2014年12月31日）以及检索到的研究的参考文献列表。
随机对照试验（包括那些采用整群随机设计的试验），比较健康计划和干预措施与对BMI大于或等于25kg/m²的育龄妇女的常规护理。仅以摘要形式发表的研究不符合纳入标准。准随机试验或采用交叉设计的随机试验不符合本综述的纳入标准。此类研究中的干预措施将涉及对孕前健康的评估，并导致制定针对该特定女性任何关注领域的个性化孕前计划。孕前干预措施可能涉及以下任何一项或全部：提供特定信息、筛查和治疗与肥胖相关的健康问题、定制或一般的饮食和运动建议、医学或手术干预。医学干预可能包括治疗既往高血压、糖耐量受损或睡眠呼吸暂停。手术干预可能包括诸如减肥手术等干预措施。对照预先指定为标准的孕前建议或无建议/干预措施。
我们未发现符合本综述纳入标准的研究。检索发现一项研究（发表在四份试验报告中），由两位综述作者独立评估，随后被排除。
无纳入试验。
我们未发现评估孕前健康计划和干预措施对超重和肥胖妇女改善妊娠结局效果的随机对照试验。在确定孕前健康计划和干预措施的有效性之前，无法提出实践建议。该领域需要进一步研究。
