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产后女性肥胖和超重管理的循证和基于共识的临床实践指南执行摘要:AIIMS-DST 倡议。

Executive summary of evidence and consensus-based clinical practice guideline for management of obesity and overweight in postpartum women: An AIIMS-DST initiative.

机构信息

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Diabetes Metab Syndr. 2022 Mar;16(3):102425. doi: 10.1016/j.dsx.2022.102425. Epub 2022 Feb 15.

Abstract

INTRODUCTION

Postpartum obesity is a public health concern. There is a need to counsel women about their postpartum weight management, accounting for various barriers they face. Limited literature in the Indian context underscored the need to develop the clinical practice guideline to be used by healthcare providers in Indian healthcare settings.

METHODS

The guideline was formulated by following the standardised methodology proposed by the National Health and Medical Research Council. Various steps such as identification of the patient population, assembly of the guideline development groups, identification of the key clinical questions, guideline development methods, grading the quality of evidence and recommendations and guideline translation were carried out to develop and validate the clinical practice recommendations.

RESULTS

The evidence and consensus-based clinical practice guideline has been developed, providing recommendations for key topics of interest for first-line treatment of obesity (lifestyle-related management). Recommendations focus on screening and initiating discussion with overweight and obese postpartum women as well as those who had normal pre-pregnancy body mass index but have retained excessive weight in the postpartum period. Recommendations highlight the evaluation and management of dietary, physical activity and breastfeeding behaviour. Recommendations also account for behavioural modification techniques to improve adherence to the prescribed weight management advice. Duration and frequency of follow-ups as well as the advice to be disseminated have also been discussed in the recommendations.

CONCLUSION

The guideline provides clinical practice points that can be used by healthcare providers, postpartum women and policymakers for opportunistic screening and management of postpartum obesity.

摘要

简介

产后肥胖是一个公共卫生关注点。有必要为女性提供产后体重管理咨询,考虑到她们面临的各种障碍。印度背景下的有限文献强调了需要制定临床实践指南,供印度医疗保健环境中的医疗保健提供者使用。

方法

该指南是按照国家健康和医学研究委员会提出的标准化方法制定的。进行了各种步骤,例如确定患者人群、组建指南制定小组、确定关键临床问题、制定指南方法、对证据和建议进行质量分级以及指南翻译,以制定和验证临床实践建议。

结果

已经制定了基于证据和共识的临床实践指南,为一线肥胖治疗(与生活方式相关的管理)的关键主题提供了建议。建议侧重于对超重和肥胖的产后女性以及那些孕前身体质量指数正常但在产后期间保留了过多体重的女性进行筛查和启动讨论。建议强调了对饮食、身体活动和母乳喂养行为的评估和管理。建议还考虑了行为修正技术,以提高对规定的体重管理建议的依从性。建议还讨论了随访的持续时间和频率,以及要传播的建议。

结论

该指南提供了临床实践要点,医疗保健提供者、产后妇女和政策制定者可以利用这些要点进行机会性筛查和管理产后肥胖。

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