Else Kroener-Fresenius Center for Nutritional Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Institute of Medical Informatics, Statistics and Epidemiology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Obes Rev. 2019 Apr;20(4):527-542. doi: 10.1111/obr.12809. Epub 2018 Dec 12.
Reducing postpartum weight retention is a promising strategy for addressing the rising prevalence of overweight and obesity in women. This systematic review and meta-analysis explored whether lifestyle interventions during pregnancy have the potential to reduce weight retention at 4 months postpartum and beyond. A search of five electronic databases for randomized controlled trials comparing the effect of weight-related lifestyle interventions beginning in pregnancy on postpartum weight retention to standard prenatal care groups was performed. Postpartum weight retention data was synthesized in a random-effects meta-analysis. Data from 14 studies of 7116 participants showed that the intervention group retained statistically significant less weight than the control group (weighted mean difference: -0.73 kg, 95% CI: -1.32 to -0.14, P = 0.015). Subgroup analysis showed this effect to be largest in studies with follow-ups from 4 to 6 months (weighted mean difference: -1.32 kg, 95% CI: -2.11 to -0.53, P = 0.001), but it remained significant until 12 months postpartum (weighted mean difference: -0.68 kg, 95% CI: -1.28 to -0.09, P = 0.023). In studies of women with a body mass index above 25.0 kg/m , no significant intervention effect was observed. More high-quality studies with a follow-up beyond 12 months postpartum are needed.
降低产后体重滞留是解决女性超重和肥胖患病率上升的一种有前途的策略。本系统评价和荟萃分析探讨了孕期生活方式干预是否有可能减少产后 4 个月及以后的体重滞留。对五个电子数据库进行了检索，以寻找比较从孕期开始的与体重相关的生活方式干预对产后体重滞留的影响与标准产前保健组的随机对照试验。采用随机效应荟萃分析对产后体重滞留数据进行综合分析。来自 14 项针对 7116 名参与者的研究的数据表明，干预组比对照组体重滞留显著减少（加权平均差异：-0.73 公斤，95%可信区间：-1.32 至-0.14，P=0.015）。亚组分析显示，这种效果在随访时间为 4 至 6 个月的研究中最大（加权平均差异：-1.32 公斤，95%可信区间：-2.11 至-0.53，P=0.001），但直到产后 12 个月仍有显著意义（加权平均差异：-0.68 公斤，95%可信区间：-1.28 至-0.09，P=0.023）。在 BMI 超过 25.0kg/m 的女性研究中，未观察到显著的干预效果。需要更多具有超过 12 个月产后随访的高质量研究。
