Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.
School of Public Health and Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Obesity (Silver Spring). 2018 Mar;26(3):485-491. doi: 10.1002/oby.22070.
This study aimed to evaluate the efficacy of a home-based lifestyle intervention delivered through Parents as Teachers (PAT) to reduce excessive gestational weight gain (GWG).
This was a single-blinded randomized controlled trial conducted as part of the LIFE-Moms consortium at a single university-based tertiary care institution from October 2012 to March 2016. There were 267 socioeconomically disadvantaged (SED) African American women with overweight or obesity (BMI 25.0-45.0 kg/m before pregnancy. Participants were randomized to therapy with standard PAT alone (n = 134) or PAT plus a lifestyle intervention program embedded within the standard PAT program (PAT+) (n = 133). Both interventions were delivered in 10 biweekly home visits during pregnancy. The primary outcome was the percentage of women whose GWG exceeded the Institute of Medicine guidelines, and secondary outcomes included both weekly and total GWG.
Compared with the standard PAT group in the intent-to-treat analysis, the PAT + group gained less weekly (0.4 kg vs. 0.5 kg/wk; P = 0.04) and total (8.0 kg vs. 9.6 kg; P = 0.02) weight during gestation. Fewer participants in the PAT + group had excessive total GWG (36.1% vs. 45.9%), but the difference between groups was not statistically significant (P = 0.11).
PAT + reduced the weekly and total GWG in SED African American women with overweight or obesity at the start of pregnancy.
本研究旨在评估通过父母作为教师（PAT）提供的基于家庭的生活方式干预措施在减少过度妊娠期体重增加（GWG）方面的疗效。
这是一项单盲随机对照试验，作为 LIFE-Moms 联盟的一部分，于 2012 年 10 月至 2016 年 3 月在一所大学的三级保健机构进行。共有 267 名社会经济地位低下（SED）的非裔美国超重或肥胖女性（BMI 在怀孕前为 25.0-45.0kg/m）。参与者随机分为仅接受标准 PAT 治疗的治疗组（n=134）或在标准 PAT 方案中嵌入生活方式干预方案的 PAT+组（n=133）。两种干预措施均在怀孕期间通过 10 次两周一次的家访进行。主要结局是 GWG 超过医学研究所指南的女性比例，次要结局包括每周和总 GWG。
与意向治疗分析中的标准 PAT 组相比，PAT+组在妊娠期每周（0.4kg 比 0.5kg/wk；P=0.04）和总（8.0kg 比 9.6kg；P=0.02）体重增加较少。PAT+组中过多的总 GWG 参与者较少（36.1%比 45.9%），但组间差异无统计学意义（P=0.11）。
PAT+减少了开始妊娠时超重或肥胖的 SED 非裔美国女性的每周和总 GWG。
