Rossiter Chris, Cheng Heilok, Appleton Jessica, Campbell Karen J, Denney-Wilson Elizabeth
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia.
Matern Child Nutr. 2021 Jul;17(3):e13178. doi: 10.1111/mcn.13178. Epub 2021 Mar 29.
Early intervention is critical for addressing the challenge of childhood obesity. Yet many preventive interventions do not target infants most at risk of future overweight or obesity. This systematic review examines interventions delivered before 2 years that aim to ameliorate excess weight gain among infants at high risk of overweight or obesity, due to sociodemographic characteristics, parental weight or health status, infant feeding or health behaviours. We searched six databases for interventions: (a) delivered before age two, (b) specifically aimed at infants at high risk of childhood obesity and (c) that reported outcomes by weight status beyond 28 days. The search identified over 27,000 titles, and 49 papers from 38 studies met inclusion criteria: 10 antenatal interventions, 16 postnatal and 12 conducted both before and after birth. Nearly all targeted infant and/or maternal nutrition. Studies varied widely in design, obesity risk factors, outcomes and quality. Overall, nine interventions of varying quality reported some evidence of significantly improved child weight trajectory, although effects tended to diminish over time. Interventions that improved weight outcomes tended to engage parents for a longer period, and most offered health professional input and support. Two studies of limited quality reported significantly worse weight outcomes in the intervention group.
早期干预对于应对儿童肥胖问题至关重要。然而，许多预防性干预措施并未针对未来超重或肥胖风险最高的婴儿。本系统综述考察了在2岁之前实施的干预措施，这些措施旨在改善因社会人口学特征、父母体重或健康状况、婴儿喂养或健康行为而面临超重或肥胖高风险的婴儿的体重过度增加情况。我们在六个数据库中搜索干预措施：(a) 在2岁之前实施，(b) 专门针对儿童肥胖高风险的婴儿，以及(c) 报告了28天之后体重状况结果的措施。搜索共识别出超过27,000个标题，来自38项研究的49篇论文符合纳入标准：10项产前干预措施、16项产后干预措施以及12项在出生前后均实施的干预措施。几乎所有干预措施都针对婴儿和/或母亲的营养。各项研究在设计、肥胖风险因素、结果和质量方面差异很大。总体而言，九项质量各异的干预措施报告了一些证据，表明儿童体重轨迹有显著改善，不过随着时间推移效果往往会减弱。改善体重结果的干预措施往往会让父母参与更长时间，并且大多数都提供了健康专业人员的投入和支持。两项质量有限的研究报告称干预组的体重结果明显更差。
