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信息-动机-行为技能模型对伊朗超重和肥胖妇女孕早期预防妊娠期糖尿病自我护理行为的有效性:一项随机对照试验

The Effectiveness of Information-Motivation-Behavioral Skills Model on Self-Care Practices in Early Pregnancy to Prevent Gestational Diabetes Mellitus in Iranian Overweight and Obese Women: A Randomized Controlled Trial.

作者信息

Motahari-Tabari Narges Sadat, Nasiri-Amiri F, Faramarzi Mahbobeh, Shirvani Marjan Ahmad, Bakhtiari Afsaneh, Omidvar Shabnam

机构信息

Department of Midwifery, School of Nursing & Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Midwifery and Reproductive Health, Faculty of Nursing & Midwifery, Babol University of Medical Sciences, Babol, I.R Iran.

出版信息

Community Health Equity Res Policy. 2023 Apr;43(3):257-264. doi: 10.1177/0272684X211020300. Epub 2021 May 30.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors. The aim of this study was to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing GDM in overweight and obese pregnant women.

METHODS

This randomized controlled trial study was conducted on 137 pregnant women in two groups; education and counseling IMB model-based for four sessions ( = 70), and antenatal usual care (AUC) ( = 67). This study was conducted on overweight and obese pregnant women, at the 12 to 16 weeks' gestation and recruited from the Prenatal Clinic of Rohani Hospital in north of Iran. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, frequency, t-test, chi-square and ANCOVA were used.

RESULTS

The prevalence of GDM was lower in the intervention group than the control group (10% and 29.9%, respectively, RR = 0.33, CI 95% (0.15- 0.74)  = .004) as well as mean fasting blood glucose (Cohen's  = 0.28,  = .07), and glucose tolerance test at the first and second hour ( = 0.41 and Cohen's  = 0.73, respectively,  < .01).

CONCLUSIONS

A lifestyle intervention in early pregnancy by IMB counseling in overweight and obese pregnant women can be effective in decrease GDM.

摘要

背景

妊娠期糖尿病(GDM)是孕期最常见的代谢功能障碍之一,超重和肥胖是主要危险因素。本研究旨在确定基于信息 - 动机 - 行为技能(IMB)模型的咨询对预防超重和肥胖孕妇发生GDM的效果。

方法

本随机对照试验研究对137名孕妇进行了两组分组;基于IMB模型进行四节教育和咨询课程(n = 70),以及产前常规护理(AUC)(n = 67)。本研究针对超重和肥胖孕妇,在妊娠12至16周时进行,从伊朗北部罗哈尼医院的产前诊所招募。在干预前和干预8周后测量血糖。使用了包括均值、频率、t检验、卡方检验和协方差分析在内的描述性和推断性统计方法。

结果

干预组的GDM患病率低于对照组(分别为10%和29.9%,RR = 0.33,95%CI(0.15 - 0.74)= 0.004),以及空腹血糖均值(科恩d = 0.28,p = 0.07),以及第一小时和第二小时的葡萄糖耐量试验(分别为d = 0.41和科恩d = 0.73,p < 0.01)。

结论

对超重和肥胖孕妇在孕早期通过IMB咨询进行生活方式干预可有效降低GDM的发生。

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