孕期尿渗透压的变化：超重和肥胖女性的一项纵向、随机对照试验。
Variation in urine osmolality throughout pregnancy: a longitudinal, randomized-control trial among women with overweight and obesity.
机构信息
Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA.
Department of Anthropology, Pennsylvania State University, University Park, PA, USA.
出版信息
Eur J Nutr. 2022 Feb;61(1):127-140. doi: 10.1007/s00394-021-02616-x. Epub 2021 Jul 3.
PURPOSE
Water needs increase during pregnancy, and proper hydration is critical for maternal and fetal health. This study characterized weekly hydration status changes throughout pregnancy and examined change in response to a randomized, behavioral intervention. An exploratory analysis tested how underhydration during pregnancy was associated with birth outcomes.
METHODS
The Healthy Mom Zone Study is a longitudinal, randomized-control trial intervention aiming to regulate gestational weight gain (GWG) in pregnant women with overweight/obesity (n = 27). Fourteen women received standard of care; 13 women additionally received weekly guidance on nutrition, physical activity, water intake, and health-promoting behaviors. Hydration status was measured weekly via overnight urine osmolality (Uosm) from ~ 8-36 weeks gestation; underhydration was dichotomized (Uosm ≥ 500 mOsm/kg). Gestational age- and sex-standardized birth weight and length z scores and percentiles were calculated. We used mixed-effect and linear regression models to test covariate-adjusted relationships.
RESULTS
No differences existed in Uosm or other characteristics between control and intervention women at baseline. Significant interactions (p = 0.01) between intervention and week of pregnancy on Uosm indicated intervention women maintained lower Uosm, whereas control women had a significant quadratic (inverse-U) relationship and greater Uosm in the second and early third trimesters. Results were consistent across robustness and sensitivity checks. Exploratory analyses suggest underhydration was associated with birth weight, but not length, in opposite ways in the second vs. third trimester.
CONCLUSION
A multi-component behavioral intervention helped women with overweight/obesity maintain better hydration throughout pregnancy. Future studies should confirm birth outcome results as they have important implications for early life nutrition.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03945266; registered May 10, 2019 retrospectively.
目的
怀孕期间需水量增加，适当的水分摄入对于母婴健康至关重要。本研究旨在描述整个孕期水分摄入状态的变化，并探讨随机行为干预对水分摄入变化的影响。探索性分析测试了孕期水分摄入不足与出生结局的关系。
方法
健康妈妈区研究是一项纵向、随机对照试验干预研究，旨在调节超重/肥胖孕妇的妊娠体重增加（GWG）（n=27）。14 名女性接受常规护理；13 名女性另外每周接受营养、身体活动、水摄入量和促进健康行为的指导。从妊娠 8-36 周期间，通过夜间尿液渗透压（Uosm）每周测量水分摄入状态；将水分摄入不足定义为（Uosm≥500 mOsm/kg）。计算妊娠年龄和性别标准化的出生体重和长度 z 分数和百分位数。我们使用混合效应和线性回归模型来检验协变量调整后的关系。
结果
在基线时，对照组和干预组之间的 Uosm 或其他特征没有差异。Uosm 与妊娠周之间的显著交互作用（p=0.01）表明干预组女性保持较低的 Uosm，而对照组女性在第二和早期第三孕期呈显著的二次（倒 U 型）关系和更高的 Uosm。结果在稳健性和敏感性检查中一致。探索性分析表明，在第二和第三孕期，水分摄入不足与出生体重呈相反关系，但与出生长度无关。
结论
多成分行为干预有助于超重/肥胖女性在整个孕期保持更好的水分摄入。未来的研究应确认出生结局结果，因为它们对早期生命营养具有重要意义。
试验注册
ClinicalTrials.gov 标识符：NCT03945266；2019 年 5 月 10 日回顾性注册。
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