Carolan-Olah Mary, Sayakhot Padaphet
College of Health and Biomedicine, Victoria University, St Albans Campus, McKechnie Road, St Albans, Victoria 3021, Australia.
College of Health and Biomedicine, Victoria University, St Albans Campus, McKechnie Road, St Albans, Victoria 3021, Australia.
Midwifery. 2019 Jan;68:39-47. doi: 10.1016/j.midw.2018.08.019. Epub 2018 Sep 5.
This study aimed to investigate changes in maternal body mass index (BMI), blood pressure and glycemic level and infant birthweight using an online educational program compared to standard clinic-based GDM education.
A preliminary randomized controlled trial of the online intervention was conducted in Melbourne, Australia between 2014 and 2015. A total of 110 women were randomized to (1) the control group and received standard clinic-based GDM education; or (2) the intervention group and received standard care plus the web-based education program. Data were collected at two time points: baseline and 12 weeks postpartum. Infant birthweight was also recorded. Chi-squared test, independent t-test and paired t-test were used to compare outcomes.
Pregnant women with newly diagnosed GDM, in the Western region of Melbourne, Australia.
Statistically significant differences were reported between intervention and control groups in maternal weight and glycemia post-intervention (p < 0.05). More women in the intervention group than in the control group reported weight loss post-intervention (90.4% vs 48.3%, p < 0.001), and were considered a healthy weight (BMI = 18.5, 24.9kg/m) at 12 weeks postpartum (44.2% vs 31%). More women in the intervention group had attended for follow up OGTT at 12 weeks postpartum (96.2% vs 70.7%, p < 0.001). Comparing measures pre- and post-intervention in the intervention group, maternal BMI was lower [(28.60 ± 7.93) vs (29.60 ± 8.32); p = 0.000], maternal systolic blood pressure was increased but within normal range [(108.19 ± 11.80) vs (107.29 ± 12.13); p = 0.001], and maternal glycemic level returned to within normal limits [(4.86 ± 0.42) vs (8.80 ± 2.50); p = 0.026]. Most women in both groups gave birth to normal birthweight infants (92.3% and 94.8%). These findings are offset by differences in the groups at baseline.
Findings suggest that the education intervention had a positive impact on women's postpartum weight and attendance at OGTT by 12 weeks postpartum. No effect was found on maternal blood pressure or infant birthweight. Further studies with matched intervention and control groups are needed to achieve more definitive conclusions.
本研究旨在调查与基于标准门诊的妊娠期糖尿病（GDM）教育相比，使用在线教育项目对孕妇体重指数（BMI）、血压和血糖水平以及婴儿出生体重的影响。
2014年至2015年在澳大利亚墨尔本进行了一项在线干预的初步随机对照试验。共有110名女性被随机分为：（1）对照组，接受基于标准门诊的GDM教育；或（2）干预组，接受标准护理加基于网络的教育项目。在两个时间点收集数据：基线和产后12周。还记录了婴儿出生体重。使用卡方检验、独立t检验和配对t检验比较结果。
澳大利亚墨尔本西部地区新诊断为GDM的孕妇。
干预组和对照组在干预后孕妇体重和血糖方面存在统计学上的显著差异（p<0.05）。干预组中报告干预后体重减轻的女性多于对照组（90.4%对48.3%，p<0.001），并且在产后12周时被认为体重健康（BMI = 18.5，24.9kg/m）（44.2%对31%）。干预组中更多女性在产后12周参加了后续口服葡萄糖耐量试验（OGTT）（96.2%对70.7%，p<0.001）。比较干预组干预前后的指标，孕妇BMI较低[（28.60±7.93）对（29.60±8.32）；p = 0.000]，孕妇收缩压升高但在正常范围内[（108.19±11.80）对（-107.29±12.13）；p = 0.001]，孕妇血糖水平恢复到正常范围内[（4.86±0.42）对（8.80±2.50）；p = 0.026]。两组中大多数女性分娩出正常出生体重的婴儿（92.3%和94.8%）。这些结果被基线时两组之间的差异所抵消。
研究结果表明，教育干预对女性产后体重和产后12周参加OGTT有积极影响。未发现对孕妇血压或婴儿出生体重有影响。需要对匹配的干预组和对照组进行进一步研究以得出更明确的结论。
