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超重或肥胖孕妇限制孕期体重增加的干预措施的综合评价。

An integrative review of interventions for limiting gestational weight gain in pregnant women who are overweight or obese.

机构信息

College of Medicine and Public Health, Flinders University, Australia.

School of Nursing and Midwifery, Deakin University, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Australia.

出版信息

Women Birth. 2022 Mar;35(2):108-126. doi: 10.1016/j.wombi.2021.04.009. Epub 2021 May 3.

Abstract

PROBLEM

Excessive gestational weight gain in women who are overweight or obese puts them at risk of poor short- and long-term outcomes for maternal and neonatal health. Several interventions have been trialled to encourage women who are overweight or obese to limit gestational weight gain during pregnancy.

AIM

The aim of this review was to analyse the evidence on interventions to limit gestational weight gain in pregnant women who are overweight or obese.

METHOD

An integrative review guided by the Joanna Briggs Institute approach was conducted. An unlabeled search query of pregnancy, weight, and obesity was conducted in Medline, Scopus and CINAHL, limited to English language, 2010-2020 publications, and primary research on humans. Unlabeled search query of "((pregnancy outcome) OR (prenatal care) OR (pregnancy complications)) AND ((weight loss) OR (weight gain) OR (weight management)) AND (obesity) was used. Additional 9 records were identified through reference lists. Following a critical appraisal, 21 primary research articles were included in this review. A thematic synthesis was undertaken.

FINDINGS

Four major themes were identified. These are (1) mixed findings of lifestyle interventions for weight management, (2) ineffectiveness of probiotics or metformin for weight management, (3) psycho-behavioural interventions for weight management, and (4) midwifery role as an integral component in multidisciplinary intervention for weight management.

CONCLUSION

The literature suggests a need for longer duration of behavioural lifestyle intervention sessions led by the same midwife trained in motivational interviewing to limit weight gain in pregnant women who are overweight or obese.

摘要

问题

超重或肥胖的女性在怀孕期间体重过度增加会增加其母婴健康的短期和长期不良结局的风险。已经尝试了几种干预措施来鼓励超重或肥胖的女性在怀孕期间限制体重增加。

目的

本综述旨在分析限制超重或肥胖孕妇体重增加的干预措施的证据。

方法

本综述采用 Joanna Briggs 研究所方法进行综合分析。在 Medline、Scopus 和 CINAHL 中进行了未标记的搜索查询,检索词为 pregnancy、weight 和 obesity,语言限定为英语,检索时间范围为 2010-2020 年,研究对象为人类。使用了未标记的搜索查询 "((pregnancy outcome) OR (prenatal care) OR (pregnancy complications)) AND ((weight loss) OR (weight gain) OR (weight management)) AND (obesity)。通过参考文献列表又确定了 9 篇记录。经过批判性评价,本综述纳入了 21 篇原始研究文章。采用主题综合法进行分析。

结果

确定了四个主要主题。分别是:(1) 生活方式干预体重管理的混合结果,(2) 益生菌或二甲双胍对体重管理无效,(3) 心理行为干预体重管理,以及 (4) 助产士在多学科体重管理干预中的重要作用。

结论

文献表明,需要由接受过动机访谈培训的同一位助产士进行更长时间的行为生活方式干预课程,以限制超重或肥胖孕妇的体重增加。

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