肥胖孕妇生活方式干预对学龄前儿童神经认知发育及人体测量学指标的影响
Effect of Lifestyle Interventions in Obese Pregnant Women on the Neurocognitive Development and Anthropometrics of Preschool Children.
作者信息
Braeken Marijke Anne Katrien Alberta, Bogaerts Annick
机构信息
Research Unit Resilient People, Faculty of Health and Social Work, University Colleges Leuven-Limburg, Diepenbeek, Belgium.
Rehabilitation Research Center, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
出版信息
Obes Facts. 2020;13(2):256-266. doi: 10.1159/000506690. Epub 2020 Apr 8.
INTRODUCTION
Maternal obesity and excessive gestational weight gain are related to adverse outcomes in women and children. Lifestyle interventions during pregnancy showed positive effects on decreasing weight gain during pregnancy, but effects on offspring's health and wellbeing are unclear. We aimed to assess the effect of lifestyle intervention programmes on offspring mental health, temperament, eating habits and anthropometric and cardiovascular measures.
METHODS
Ninety-six offspring of pregnant women with a body mass index (BMI) ≥29 kg/m2 who were randomly assigned to 3 intervention groups during pregnancy (routine antenatal care, a brochure group or a prenatal session group) and 77 offspring of pregnant women with a normal BMI (between 18.5 and 24.9 kg/m2) were used as an additional control group in this analysis. When the children were between 3 and 7 years old, anthropometric and cardiovascular measurements were conducted and various questionnaires about offspring mental health, temperament and eating habits were filled out.
RESULTS
Children of mothers who received a brochure-based lifestyle intervention programme showed significantly less surgency/extraversion compared to children of mothers who received routine antenatal care (contrast estimate = -0.36, SE = 0.15, p = 0.02, 95% CI [-6.66, -0.06]) and prenatal lifestyle intervention sessions (contrast estimate = -0.46, SE = 0.14, p < 0.01, 95% CI [-0.74, -0.18]) after adjusting for child's age, sex, offspring birth weight and mother's educational level. The lifestyle intervention could not be associated with any significant differences in offspring mental health, eating habits and anthropometric and cardiovascular characteristics. Children of mothers with a normal BMI showed less emotional problems (F(1, 156) = 5.42, p = 0.02) and internalizing (F(1, 156) = 3.04, p = 0.08) and externalizing problems (F(1, 156) = 6.10, p = 0.02) when compared to children of mothers in the obese group.
DISCUSSION/CONCLUSION: The results suggest that a brochure-based lifestyle intervention programme can affect the offspring temperament. Future follow-up studies need to investigate how these temperament-related effects may influence obesity development later in life.
引言
孕妇肥胖和孕期体重过度增加与母婴不良结局相关。孕期生活方式干预对减少孕期体重增加有积极作用，但对后代健康和幸福的影响尚不清楚。我们旨在评估生活方式干预项目对后代心理健康、气质、饮食习惯以及人体测量和心血管指标的影响。
方法
本分析中，将96名体重指数（BMI）≥29 kg/m² 的孕妇的后代在孕期随机分为3个干预组（常规产前护理组、宣传册组或产前课程组），并将77名BMI正常（18.5至24.9 kg/m² 之间）的孕妇的后代作为额外对照组。当孩子3至7岁时，进行人体测量和心血管测量，并填写关于后代心理健康、气质和饮食习惯的各种问卷。
结果
在调整孩子年龄、性别、后代出生体重和母亲教育水平后，与接受常规产前护理的母亲的孩子相比，接受基于宣传册的生活方式干预项目的母亲的孩子表现出显著更少的冲动/外向性（对比估计值=-0.36，标准误=0.15，p=0.02，95%置信区间[-6.66，-0.06]），与接受产前生活方式干预课程的母亲的孩子相比也是如此（对比估计值=-0.46，标准误=0.14，p<0.01，95%置信区间[-0.74，-0.18]）。生活方式干预与后代心理健康、饮食习惯以及人体测量和心血管特征方面的任何显著差异均无关联。与肥胖组母亲的孩子相比，BMI正常的母亲的孩子表现出更少的情绪问题（F(1, 156)=5.42，p=0.02）、内化问题（F(1, 156)=3.04，p=0.08）和外化问题（F(1, 156)=6.10，p=0.02）。
讨论/结论：结果表明，基于宣传册的生活方式干预项目可影响后代气质。未来的随访研究需要调查这些与气质相关的影响如何可能在以后的生活中影响肥胖的发展。
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