Gilmore L Anne, Klempel Monica C, Martin Corby K, Myers Candice A, Burton Jeffrey H, Sutton Elizabeth F, Redman Leanne M
Pennington Biomedical Research Center , Baton Rouge, Louisiana.
J Womens Health (Larchmt). 2017 Jul;26(7):719-727. doi: 10.1089/jwh.2016.5947. Epub 2017 Mar 24.
Prepregnancy maternal obesity and excessive weight gain during pregnancy lead to significant morbidities in mothers and their children. Mothers who never return to their prepregnancy weight begin subsequent pregnancies at a greater weight and have a larger propensity for excess gestational weight gain and postpartum weight retention.
In this pilot study, 40 postpartum women credentialed to receive postpartum women, infants, and children (WIC) service were randomized to usual care ("WIC Moms") or a personalized health intervention delivered via a SmartPhone ("E-Moms"). Assessments, including body weight, vital signs, circumferences, and body composition, were completed at week 0 (6-8 weeks postpartum), week 8, and week 16.
Results are presented as change from week 0 at 16. As per the completers analysis, body weight change was not different between the groups (WIC Moms vs. E-Moms; 1.8 ± 0.9 vs. -0.1 ± 0.9 kg; p = 0.10), neither was the change in percent body fat (1.7 ± 0.6 vs. 0.1% ± 0.6%; p = 0.90) or waist/hip ratio (-0.01 ± 0.01 vs. -0.02 ± 0.01 cm; p = 0.60). However, due to notable variability in intervention adherence as the study progressed, participants were classified post hoc as having low (<40% adherence), medium (40%-70% adherence), or high adherence (>70% adherence). Participants with high intervention adherence (n = 5) had a significant reduction in body weight (-3.6 ± 1.6 vs. 1.8 ± 0.9 kg; p = 0.005) and percent body fat (-2.5 ± 1.0 vs. 1.7% ± 0.6%; p = 0.001) when compared to WIC Moms.
Overall, the E-Moms intervention was not able to decrease postpartum weight retention in women receiving WIC benefits compared to usual care received through the current WIC program. However, there is some evidence to suggest improved adherence to the intervention would improve weight management.
孕前母亲肥胖以及孕期体重过度增加会给母亲及其子女带来严重疾病。从未恢复到孕前体重的母亲在随后的孕期开始时体重更高,且有更大的可能性出现孕期体重过度增加和产后体重滞留。
在这项试点研究中,40名符合条件接受产后妇女、婴儿和儿童(WIC)服务的产后女性被随机分为常规护理组(“WIC妈妈组”)或通过智能手机提供的个性化健康干预组(“电子妈妈组”)。在第0周(产后6 - 8周)、第8周和第16周完成了包括体重、生命体征、周长和身体成分在内的评估。
结果以第16周相对于第0周的变化呈现。根据完成者分析,两组之间的体重变化没有差异(WIC妈妈组与电子妈妈组;1.8±0.9 vs. -0.1±0.9千克;p = 0.10),身体脂肪百分比的变化(分别为1.7±0.6 vs. 0.1%±0.6%;p = 0.90)或腰臀比(-0.01±0.01 vs. -0.02±0.01厘米;p = 0.60)也没有差异。然而,由于随着研究进展干预依从性存在显著差异,事后将参与者分为低依从性(<40%依从性)、中等依从性(40% - 70%依从性)或高依从性(>70%依从性)。与WIC妈妈组相比,高干预依从性的参与者(n = 5)体重显著降低(-3.6±1.6 vs. 1.8±0.9千克;p = 0.005),身体脂肪百分比也显著降低(-2.5±1.0 vs. 1.7%±0.6%;p = 0.001)。
总体而言,与通过当前WIC计划接受的常规护理相比,电子妈妈组干预未能降低接受WIC福利的女性的产后体重滞留。然而,有一些证据表明提高干预依从性将改善体重管理。