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一种减少孕期体重过度增加的行为干预措施。

A Behavioral Intervention to Reduce Excessive Gestational Weight Gain.

作者信息

Krukowski Rebecca A, West Delia, DiCarlo Marisha, Shankar Kartik, Cleves Mario A, Tedford Eric, Andres Aline

机构信息

Center for Population Sciences, Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN, 38163, USA.

Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

出版信息

Matern Child Health J. 2017 Mar;21(3):485-491. doi: 10.1007/s10995-016-2127-5.

Abstract

Objectives Excessive gestational weight gain (GWG) is a key modifiable risk factor for negative maternal and child health. We examined the efficacy of a behavioral intervention in preventing excessive GWG. Methods 230 pregnant women (87.4 % Caucasian, mean age = 29.2 years; second parity) participated in the longitudinal Glowing study (clinicaltrial.gov #NCT01131117), which included six intervention sessions focused on GWG. To determine the efficacy of the intervention in comparison to usual care, participants were compared to a matched contemporary cohort group from the Arkansas Pregnancy Risk Assessment Monitoring Survey (PRAMS). Results Participants attended 98 % of intervention sessions. Mean GWG for the Glowing participants was 12.7 ± 2.7 kg for normal weight women, 12.4 ± 4.9 kg for overweight women, and 9.0 ± 4.2 kg for class 1 obese women. Mean GWG was significantly lower for normal weight and class 1 obese Glowing participants compared to the PRAMS respondents. Similarly, among those who gained excessively, normal weight and class 1 obese Glowing participants had a significantly smaller mean weight gain above the guidelines in comparison to PRAMS participants. There was no significant difference in the overall proportion of the Glowing participants and the proportion of matched PRAMS respondents who gained in excess of the Institute of Medicine GWG guidelines. Conclusions for Practice This behavioral intervention was well-accepted and attenuated GWG among normal weight and class 1 obese women, compared to matched participants. Nevertheless, a more intensive intervention may be necessary to help women achieve GWG within the Institute of Medicine's guidelines.

摘要

目标 孕期体重过度增加(GWG)是母婴健康不良的一个关键可改变风险因素。我们研究了一种行为干预在预防孕期体重过度增加方面的效果。方法 230名孕妇(87.4%为白种人,平均年龄 = 29.2岁;经产)参与了纵向的“光彩照人”研究(clinicaltrial.gov编号#NCT01131117),该研究包括六次聚焦于孕期体重增加的干预课程。为了确定该干预与常规护理相比的效果,将参与者与来自阿肯色州妊娠风险评估监测调查(PRAMS)的匹配当代队列组进行比较。结果 参与者参加了98%的干预课程。“光彩照人”研究中的正常体重女性参与者的平均孕期体重增加为12.7±2.7千克,超重女性为12.4±4.9千克,1级肥胖女性为9.0±4.2千克。与PRAMS调查对象相比,正常体重和1级肥胖的“光彩照人”研究参与者的平均孕期体重增加显著更低。同样,在体重增加过多的人群中,正常体重和1级肥胖的“光彩照人”研究参与者的平均体重增加量显著低于PRAMS参与者超出指南规定的量。“光彩照人”研究参与者总体比例与匹配的PRAMS调查对象中超过医学研究所孕期体重增加指南标准的比例之间没有显著差异。实践结论 与匹配的参与者相比,这种行为干预在正常体重和1级肥胖女性中得到了良好接受,并减轻了孕期体重增加。然而,可能需要更强化的干预来帮助女性在医学研究所的指南范围内实现孕期体重增加。

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