Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts.
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island.
Am J Prev Med. 2021 Jul;61(1):44-54. doi: 10.1016/j.amepre.2021.02.005. Epub 2021 May 13.
This study assesses the impact of a culturally modified, motivationally targeted, individually tailored intervention on postpartum weight retention among Hispanic women with abnormal glucose tolerance during pregnancy.
Estudio Parto (Project Aiming to Reduce Type twO diabetes) was an RCT conducted in Western Massachusetts (collected 2013‒2017, analyzed 2018-2020). Hispanic women with blood glucose ≥140 mg/dL (7.77 mmol/L) on routine nonfasting oral glucose challenge test were randomized to a Lifestyle Intervention (n=100) focusing on healthy exercise and diet or to a comparison Health and Wellness Intervention (n=104) with no mention of exercise or diet behavior changes. The primary outcome was change in weight, calculated as the difference between prepregnancy weight and 6-week, 6-month, and 12-month postpartum weight. The secondary outcome was achievement of weight reduction to prepregnancy weight if prepregnancy BMI was normal, or a 5% reduction if prepregnancy BMI was overweight/obese.
In intent-to-treat analyses, there were no significant differences in weight change pattern between the intervention arms across all follow-up timepoints (β=0.03, 95% CI= -3.38, 3.45). However, at 12 months postpartum, women in the Lifestyle Intervention arm had a statistically significant 2.5-fold higher odds of meeting the secondary weight reduction outcome (OR=2.52, 95% CI=1.09, 5.82) than women in the Health and Wellness arm. Regardless of intervention arm, women who reported higher levels of postpartum sports/exercise had a greater decrease in weight (β= -2.39, 95% CI= -4.66, -0.13, p=0.04) than women reporting lower levels.
In this randomized trial among Hispanic women, no significant overall differences in weight change pattern between intervention arms were observed. Higher levels of self-reported physical activity were associated with greater weight loss in both arms.
本研究评估了一项文化改良、以动机为目标、个体化定制的干预措施对妊娠期血糖异常的西班牙裔女性产后体重滞留的影响。
Estudio Parto（旨在减少 2 型糖尿病的项目）是在马萨诸塞州西部进行的一项 RCT（收集于 2013-2017 年，分析于 2018-2020 年）。在常规非空腹口服葡萄糖耐量试验中血糖≥140mg/dL（7.77mmol/L）的西班牙裔女性被随机分配到生活方式干预组（n=100），重点是健康运动和饮食，或到对照组健康和健康干预组（n=104），没有提到运动或饮食行为的改变。主要结局是体重变化，计算方法是孕前体重与 6 周、6 个月和 12 个月产后体重的差值。次要结局是如果孕前 BMI 正常，则体重恢复到孕前体重；如果孕前 BMI 超重/肥胖，则体重减轻 5%。
在意向治疗分析中，在所有随访时间点，干预组之间的体重变化模式没有显著差异（β=0.03，95%CI=-3.38，3.45）。然而，在产后 12 个月时，生活方式干预组的女性达到次要体重减轻目标的几率明显高出 2.5 倍（OR=2.52，95%CI=1.09，5.82），而健康和健康组的女性则高出 2.5 倍。无论干预组如何，报告产后运动/锻炼水平较高的女性体重下降幅度更大（β=-2.39，95%CI=-4.66，-0.13，p=0.04）。
在这项针对西班牙裔女性的随机试验中，干预组之间的体重变化模式没有观察到总体显著差异。较高水平的自我报告身体活动与两个组的体重减轻都有关。
