Tussing-Humphreys Lisa M, Thomson Jessica L, Hemphill Nefertiti OjiNjideka, Goodman Melissa H, Landry Alicia S
Department of Medicine and Cancer Center, University of Illinois at Chicago, 416 West Side Research Office Building, 1747 West Roosevelt Road, Chicago, IL 60608 USA.
United States Department of Agriculture, Agricultural Research Service, Delta Human Nutrition Research Program, 141 Experiment Station Road, Stoneville, MS 38776 USA.
Matern Health Neonatol Perinatol. 2017 Dec 4;3:20. doi: 10.1186/s40748-017-0058-9. eCollection 2017.
Excessive postnatal weight retention may pose a threat to a woman's health and future pregnancies. Women in the Lower Mississippi Delta (LMD) region of Mississippi suffer from among the highest rates of obesity in the U.S. and are more likely to gain an excessive amount of weight during pregnancy. The aim of this study was to determine if LMD women who received a lifestyle enhanced maternal, infant, and early childhood home visiting (MIECHV) curriculum had more favorable weight outcomes through 12-months postpartum compared to women who received a standard MIECHV curriculum.
Delta Healthy Sprouts was a two-arm, randomized, controlled, comparative impact trial. Pregnant women at least 18 years of age, less than 19 weeks pregnant with a singleton pregnancy, and residing in the LMD region were recruited. On a monthly basis in the participant's home, the control arm (PAT) received the Parents as Teachers curriculum while the experimental arm (PATE) received a lifestyle enhanced Parents as Teachers curriculum. Pre-pregnancy body weight via self-report and maternal body weight at baseline (gestational month 4) and at every subsequent monthly visit through 12 months postpartum was measured. Linear mixed models were used to test for significant treatment, time, and treatment by time effects on postnatal weight outcomes.
Mean postnatal weight losses were 0.8 and 1.1 kg at postnatal month (PM) 6 and PM 12, respectively, for PAT participants. Mean postnatal weight losses for PATE participants were 1.5 and 1.2 kg at PM 6 and PM 12, respectively. Mean weight retention, based on pre-pregnancy weight, were 5.2, 4.0, and 3.6 kg at PM 1, PM 6, and PM 12, respectively, for PAT participants. Mean weight retention for PATE participants were 6.3, 4.5, and 4.0 kg at PM 1, PM 6, and PM 12, respectively. Significant effects were not found for treatment, time, or treatment by time.
An enhanced MIECHV curriculum was not associated with more favorable postpartum weight outcomes when compared to a standard MIECHV curriculum in a cohort of LMD women during the 12 months following the birth of their infant. Trial registration: clinicaltrials.gov, NCT01746394. Registered 5 December 2012.
产后体重过度增加可能对女性健康及未来妊娠构成威胁。密西西比州下密西西比三角洲（LMD）地区的女性肥胖率位居美国前列，且孕期更易体重过度增加。本研究旨在确定与接受标准母婴及儿童早期家庭访视（MIECHV）课程的女性相比，接受强化生活方式的母婴及儿童早期家庭访视课程的LMD地区女性在产后12个月内体重结局是否更佳。
“三角洲健康萌芽”研究是一项双臂、随机、对照、比较影响试验。招募年龄至少18岁、单胎妊娠且孕周小于19周、居住在LMD地区的孕妇。在参与者家中每月进行一次访视，对照组（PAT）接受“家长即教师”课程，试验组（PATE）接受强化生活方式的“家长即教师”课程。通过自我报告测量孕前体重，并在基线时（妊娠4个月）及产后每月直至12个月测量产妇体重。使用线性混合模型测试治疗、时间及治疗与时间交互作用对产后体重结局的显著影响。
PAT组参与者在产后第6个月（PM6）和第12个月（PM12）的平均产后体重减轻分别为0.8千克和1.1千克。PATE组参与者在PM6和PM12的平均产后体重减轻分别为1.5千克和1.2千克。基于孕前体重，PAT组参与者在产后第1个月（PM1）、PM6和PM12的平均体重增加分别为5.2千克、4.0千克和3.6千克。PATE组参与者在PM1、PM6和PM12的平均体重增加分别为6.3千克、4.5千克和4.0千克。未发现治疗、时间或治疗与时间交互作用的显著影响。
在LMD地区一组女性产后12个月内，与标准MIECHV课程相比，强化MIECHV课程与更佳的产后体重结局无关。试验注册：clinicaltrials.gov，NCT01746394。2012年12月5日注册。
