Discipline of Obstetrics & Gynaecology, and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
Women's and Babies Division, Department of Perinatal Medicine, The Women's and Children's Hospital, North Adelaide, SA, Australia.
Int J Obes (Lond). 2018 Jul;42(7):1326-1335. doi: 10.1038/s41366-018-0019-z. Epub 2018 Jan 30.
The immediate impact of providing an antenatal dietary intervention during pregnancy has been extensively studied, but little is known of the effects beyond the neonatal period. Our objective was to evaluate the effect of an antenatal dietary intervention in overweight or obese women on infant outcomes 6 months after birth.
We conducted a follow up study of infants born to women who participated in the LIMIT trial during pregnancy. Live-born infants at 6-months of age, and whose mother provided consent to ongoing follow-up were eligible. The primary follow-up study endpoint was the incidence of infant BMI z-score ≥90th centile for infant sex and age. Secondary study outcomes included a range of infant anthropometric measures, neurodevelopment, general health, and infant feeding. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Missing data were imputed and analyses adjusted for maternal early pregnancy BMI, parity, study centre, socioeconomic status, age, and smoking status. Outcome assessors were blinded to the allocated treatment group.
A total of 1754 infants were assessed at age 6 months (Lifestyle Advice n = 869; Standard Care n = 885), representing 82.1% of the eligible sample (n = 2136). There were no statistically significant differences in the incidence of infant BMI z-score ≥90th centile for infants born to women in the Lifestyle Advice group, compared with the Standard Care group (Lifestyle Advice 233 (21.71%) vs. Standard Care 233 (21.90%); adjusted relative risk (aRR) 0.99; 95% confidence interval 0.82 to 1.18; p = 0.88). There were no other effects on infant growth, adiposity, or neurodevelopment.
Providing pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention did not alter 6-month infant growth and adiposity.
Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
孕期提供产前饮食干预的即时影响已得到广泛研究,但对于新生儿期后影响知之甚少。我们的目的是评估超重或肥胖孕妇接受产前饮食干预对婴儿出生后 6 个月的影响。
我们对参与 LIMIT 试验的孕妇所生的婴儿进行了随访研究。在 6 个月龄时存活并获得母亲继续随访同意的活产婴儿有资格参加。主要随访研究终点是婴儿性别和年龄的 BMI z 评分≥第 90 百分位数的发生率。次要研究结果包括一系列婴儿人体测量指标、神经发育、一般健康状况和婴儿喂养情况。分析采用根据妊娠时分配的治疗组进行意向治疗原则。对缺失数据进行了插补,并根据母亲早孕 BMI、产次、研究中心、社会经济状况、年龄和吸烟状况进行了调整。结果评估者对分配的治疗组不知情。
共有 1754 名婴儿在 6 个月龄时接受了评估(生活方式建议组 n=869;标准护理组 n=885),占合格样本的 82.1%(n=2136)。与标准护理组相比,生活方式建议组婴儿的 BMI z 评分≥第 90 百分位数的发生率没有统计学上的显著差异(生活方式建议组 233(21.71%)vs. 标准护理组 233(21.90%);调整后的相对风险(aRR)0.99;95%置信区间 0.82 至 1.18;p=0.88)。婴儿生长、肥胖或神经发育均无其他影响。
为超重或肥胖孕妇提供产前饮食和生活方式干预并没有改变 6 个月婴儿的生长和肥胖程度。
澳大利亚和新西兰临床试验注册中心(ACTRN12607000161426)。