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微信辅助饮食和运动干预预防超重/肥胖孕妇妊娠期糖尿病:一项双臂随机临床试验。

WeChat-assisted dietary and exercise intervention for prevention of gestational diabetes mellitus in overweight/obese pregnant women: a two-arm randomized clinical trial.

机构信息

Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, 10050, China.

Department of Gynecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 10050, People's Republic of China.

出版信息

Arch Gynecol Obstet. 2021 Sep;304(3):609-618. doi: 10.1007/s00404-021-05984-1. Epub 2021 Feb 11.

Abstract

PURPOSE

This study aimed to examine the influence of a WeChat-based dietary and exercise intervention on gestational diabetes mellitus (GDM) prevention in overweight/obese pregnant women in Beijing.

METHODS

Overweight/obese pregnant women were recruited in the early stages of pregnancy. After screening by include and exclude standards, eligible women were randomly divided into two groups, intervention and control groups. The control group received a general advice session about pregnancy nutrition and weight management. The intervention group received three face-to-face sessions about personalized dietary and exercise intervention, with the help of WeChat as a monitoring tool to promote treatment plan adherence. At 24-28 weeks of pregnancy, GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Gestational weight gain (GWG), maternal and neonatal outcomes were also collected.

RESULTS

This study analyzed 215 participants. At the mid-trimester, 42 (37.8%) women in the control group were diagnosed with GDM (n = 111) versus 25 (24.5%) in the intervention group (n = 104; p < 0.05). The intervention group gained 11.2 ± 4.9 kg during the whole gestation period, with 4.9 ± 3.1 kg-weight increment in the first 25 weeks of pregnancy, versus 13.4 ± 5.0 kg and 6.9 ± 3.2 kg in the first 25 weeks in the control group (between groups: p < 0.001/p = 0.002). Incidence of macrosomia was not significantly lower in the intervention group than in the control group (8/7.9% vs 11/9.9%) (p > 0.05). No significant difference was found in the rate of natural labor and occurrence of perinatal complications (e.g., preterm birth, gestational hypertension, and preeclampsia) between the groups (p > 0.05).

CONCLUSIONS

The WeChat-assisted dietary and exercise intervention was effective in reducing the occurrence of GDM and excessive weight gain in overweight/obese pregnant women. Disseminating knowledge of pregnancy and childbirth through social media platforms like WeChat could be an important part of antenatal care.

摘要

目的

本研究旨在探讨基于微信的饮食和运动干预对北京超重/肥胖孕妇妊娠期糖尿病(GDM)预防的影响。

方法

在妊娠早期招募超重/肥胖孕妇。经过纳入和排除标准筛选后,合格的孕妇被随机分为两组,干预组和对照组。对照组接受关于妊娠营养和体重管理的一般建议。干预组接受三次关于个性化饮食和运动干预的面对面会议,并借助微信作为监测工具来促进治疗计划的依从性。在妊娠 24-28 周时,根据国际妊娠糖尿病研究组(IADPSG)标准诊断 GDM。还收集了妊娠体重增加(GWG)、母婴结局等数据。

结果

本研究共分析了 215 名参与者。在孕中期,对照组中有 42 名(37.8%)女性被诊断为 GDM(n=111),而干预组中有 25 名(24.5%)(n=104;p<0.05)。干预组整个孕期体重增加 11.2±4.9kg,妊娠前 25 周体重增加 4.9±3.1kg,而对照组分别为 13.4±5.0kg 和 6.9±3.2kg(组间:p<0.001/p=0.002)。干预组巨大儿的发生率并不低于对照组(8/7.9%比 11/9.9%)(p>0.05)。两组自然分娩率和围产期并发症发生率(如早产、妊娠期高血压和子痫前期)无显著差异(p>0.05)。

结论

微信辅助饮食和运动干预可有效降低超重/肥胖孕妇 GDM 和体重过度增加的发生率。通过微信等社交媒体平台传播妊娠和分娩知识可能是产前保健的重要组成部分。

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