van Dijk Matthijs R, Koster Maria P H, Oostingh Elsje C, Willemsen Sten P, Steegers Eric A P, Steegers-Theunissen Régine P M
Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.
Department of Biostatistics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.
J Med Internet Res. 2020 May 15;22(5):e15773. doi: 10.2196/15773.
Unhealthy nutrition contributes to the worldwide rising prevalence of noncommunicable diseases. As most adverse reproductive outcomes originate during the periconception period, effective interventions targeting this period are needed. Therefore, we developed the lifestyle intervention Smarter Pregnancy to empower women to adapt a healthy diet prior to conception and during early pregnancy and performed a randomized controlled trial.
The objectives of this trial were to investigate compliance and effectiveness in women using the Smarter Pregnancy program.
Women aged between 18 and 45 years who were contemplating pregnancy or <13 weeks pregnant and their male partners living in the urban area of Rotterdam, the Netherlands, were eligible for participation. After baseline screening, the intervention group received personal online coaching based on identified inadequate intakes of vegetables, fruits, and folic acid supplements. The sum of these risk factors was used as a dietary risk score (DRS), ranging from 0 (healthy) to 9 (unhealthy). The control group did not receive coaching. We applied an intention-to-treat principle and used a multivariable linear regression model to evaluate the change in DRS after 24 weeks. Compliance was defined as the percentage of women who completed the screening questionnaire at 24 weeks.
Of women recruited, 81.2% (177/218) completed the program (intervention: 91/218, 83.5%; control: 86/218, 78.9%; P=.95). After 24 weeks, the reduction in DRS of women in the intervention group was significantly larger than in the control group (β=.75, 95% CI 0.18-1.34). This reduction was mainly due to increased vegetable intake (β=.55, 95% CI 0.25-0.86).
The high compliance and the larger improvements in nutritional behaviors, especially vegetable intake, in women in the intervention group emphasizes the effectiveness of empowering women by using the lifestyle change intervention Smarter Pregnancy.
Netherlands Trial Register: NL3927; https://www.trialregister.nl/trial/3927.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12884-017-1228-5.
不健康的营养状况导致全球非传染性疾病患病率不断上升。由于大多数不良生殖结局始于围孕期，因此需要针对这一时期采取有效的干预措施。为此，我们开发了生活方式干预项目“更明智的孕期”，以促使女性在孕前和孕早期采用健康饮食，并开展了一项随机对照试验。
本试验的目的是调查使用“更明智的孕期”项目的女性的依从性和有效性。
年龄在18至45岁之间、计划怀孕或怀孕未满13周的女性及其居住在荷兰鹿特丹市区的男性伴侣有资格参与。基线筛查后，干预组根据确定的蔬菜、水果和叶酸补充剂摄入量不足情况接受个人在线指导。这些风险因素的总和用作饮食风险评分（DRS），范围从0（健康）到9（不健康）。对照组未接受指导。我们采用意向性分析原则，并使用多变量线性回归模型评估24周后DRS的变化。依从性定义为在24周时完成筛查问卷的女性百分比。
在招募的女性中，81.2%（177/218）完成了该项目（干预组：91/218，83.5%；对照组：86/218，78.9%；P = 0.95）。24周后，干预组女性的DRS降低幅度显著大于对照组（β = 0.75，95%CI 0.18 - 1.34）。这种降低主要归因于蔬菜摄入量的增加（β = 0.55，95%CI 0.25 - 0.86）。
干预组女性的高依从性以及营养行为尤其是蔬菜摄入量的更大改善，强调了通过生活方式改变干预项目“更明智的孕期”赋予女性权力的有效性。
荷兰试验注册库：NL3927；https://www.trialregister.nl/trial/3927。
国际注册报告标识符（IRRID）：RR2 - 10.1186/s12884 - 017 - 1228 - 5。
