Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.
Department of Nutritional Sciences, King's College London, School of Life Course Sciences, London, UK.
Matern Child Nutr. 2018 Oct;14(4):e12628. doi: 10.1111/mcn.12628. Epub 2018 Jul 1.
Evidence suggests that adverse nutritional exposures during in utero development may contribute to heightened risk of obesity in childhood. Pregnancy offers the opportunity to modify the intrauterine environment by manipulation of diet and/or physical activity, which may result in favourable health benefits for the child. The objective of this systematic review was to determine whether antenatal lifestyle interventions in pregnant women, aimed at modifying diet and/or physical activity, and lead to a reduction in measures of offspring obesity in early childhood. Three electronic databases were searched from January 1990 to July 2017 for antenatal interventions with subsequent offspring follow-up publications. Eight trials were identified. Five trials included women from all body mass index categories, and 3 trials included obese women only. Children in the offspring follow-up studies were aged 6 months to 7 years. Measures of adiposity in the offspring (n = 1989) included weight, body mass index, z-scores, circumferences, and skinfold thicknesses. Two studies, focusing on obese women only, reported reduced measures of adiposity (subscapular skinfold thickness and weight-for-age z-score) at 6 and 12 months, respectively. The remaining 6 studies, two from infancy and 4 in early childhood found no effect on measures of adiposity. Measures of obesity up to 12 months of age have been shown to be reduced by antenatal lifestyle interventions during pregnancy in obese women. Due to the heterogeneity of the methodology of the antenatal interventions and the reported offspring outcomes we were unable to draw any conclusion on the influence of antenatal interventions on measures of obesity in early childhood.
有证据表明，胎儿期的不良营养暴露可能会增加儿童肥胖的风险。怀孕为通过饮食和/或体育活动来改变宫内环境提供了机会，这可能会给孩子带来有利的健康益处。本系统评价的目的是确定针对孕妇的产前生活方式干预措施是否可以改变饮食和/或体育活动，从而降低幼儿肥胖的测量值。从 1990 年 1 月至 2017 年 7 月，三个电子数据库都对旨在改变饮食和/或体育活动的产前干预措施及其随后的后代随访出版物进行了搜索。确定了八项试验。五项试验纳入了所有 BMI 类别的女性，三项试验仅纳入了肥胖女性。后代随访研究中的儿童年龄在 6 个月至 7 岁之间。后代的肥胖指标（n=1989）包括体重、体重指数、z 评分、周长和皮褶厚度。两项研究仅关注肥胖女性，分别报告了 6 个月和 12 个月时减少了皮下脂肪厚度和体重-年龄 z 评分等肥胖指标。其余 6 项研究，其中 2 项在婴儿期进行，4 项在幼儿期进行，均未发现肥胖指标有任何变化。已表明，在怀孕期间对肥胖女性进行产前生活方式干预可以降低肥胖的肥胖指标，直至 12 个月大。由于产前干预措施的方法学和报告的后代结果存在异质性，我们无法就产前干预对幼儿肥胖指标的影响得出任何结论。
