Ronnberg AnnKristin, Hanson Ulf, Ostlund Ingrid, Nilsson Kerstin
Department of Obstetrics & Gynecology, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, Sweden.
Department of Obstetrics & Gynecology, School of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Acta Obstet Gynecol Scand. 2016 Sep;95(9):999-1007. doi: 10.1111/aogs.12910. Epub 2016 May 13.
High weight retention after pregnancy is related to an increased risk of future obesity. The objective was to evaluate whether an antenatal intervention, compared with standard care, could reduce postpartum weight retention (PPWR).
Women with body mass index >19, age ≥18 years, knowledge of Swedish, and pregnancy ≤16 weeks' gestation were randomized. Standard care was compared with a composite intervention including a personalized weight graph, education on recommended weight gain, prescription of exercise, and monitoring of weight until 1 year after delivery. Mean (kg) PPWR was compared between the groups and risk estimates (odds ratio) for excessive weight retention were calculated.
Of 445 women randomized, 267 remained for analysis at ≤16 weeks postpartum and 168 at 1 year postpartum. The intervention group had a significantly lower mean PPWR at ≤16 weeks [1.81 kg (standard deviation, SD, 4.52) vs. 3.19 kg (SD 4.77), p = 0.016]. At one year postpartum, mean retention was still 0.7 kg lower in the intervention group [0.30 kg (SD 5.52) vs. 1.00 kg (SD 5.46)]; the difference was not statistically significant (p = 0.414). Gestational weight gain above Institute of Medicine recommendations was a significant risk factor for excessive weight retention (>5 kg) one year after delivery (OR 2.44; 95% CI 1.08-5.52, p = 0.029).
A composite lifestyle intervention during pregnancy reduced short-term weight retention, but the effect of the intervention did not remain at 1 year postpartum. A gestational weight gain above Institute of Medicine recommendations increases the risk of excessive long-term weight retention.
产后体重滞留过多与未来肥胖风险增加有关。目的是评估与标准护理相比，产前干预是否能减少产后体重滞留（PPWR）。
将体重指数>19、年龄≥18岁、懂瑞典语且妊娠≤16周的女性随机分组。将标准护理与综合干预进行比较，综合干预包括个性化体重图表、关于推荐体重增加的教育、运动处方以及产后1年内的体重监测。比较两组间的平均（kg）PPWR，并计算体重滞留过多的风险估计值（比值比）。
在445名随机分组的女性中，267名在产后≤16周时仍参与分析，168名在产后1年时仍参与分析。干预组在产后≤16周时的平均PPWR显著更低[1.81 kg（标准差，SD，4.52）对3.19 kg（SD 4.77），p = 0.016]。在产后1年时，干预组的平均滞留量仍低0.7 kg[0.30 kg（SD 5.52）对1.00 kg（SD 5.46）]；差异无统计学意义（p = 0.414）。孕期体重增加超过医学研究所的建议是产后1年体重滞留过多（>5 kg）的显著危险因素（比值比2.44；95%置信区间1.08 - 5.52，p = 0.029）。
孕期综合生活方式干预可减少短期体重滞留，但干预效果在产后1年时未持续存在。孕期体重增加超过医学研究所的建议会增加长期体重滞留过多的风险。
