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mHealth 支持的产前生活方式干预可能与改善妊娠期间的产妇睡眠相关:PEARS 试验的二次分析。

An mHealth-Supported antenatal lifestyle intervention may be associated with improved maternal sleep in pregnancy: Secondary analysis from the PEARS trial.

机构信息

UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.

UCI Department of Pediatrics, University of California, Irvine, CA, USA.

出版信息

BJOG. 2022 Dec;129(13):2195-2202. doi: 10.1111/1471-0528.17267. Epub 2022 Aug 8.

Abstract

OBJECTIVE

To investigate the effect of an antenatal diet and exercise intervention during pregnancy on sleep duration. As a secondary objective, associations between sleep duration and gestational weight gain (GWG), maternal metabolic parameters and pregnancy outcomes were assessed.

DESIGN

Secondary analysis.

SETTING

Large tertiary Maternity Hospital in Dublin, Ireland.

POPULATION

326 women with overweight or obesity who participated in the Pregnancy Exercise And Nutrition Research Study (PEARS) randomised controlled trial between March 2013 and August 2016.

METHODS

Secondary analysis of a randomised trial.

MAIN OUTCOME MEASURES

Impact of the PEARS intervention on sleep duration, and association of sleep duration and maternal metabolic parameters, and pregnancy outcomes.

RESULTS

Participants had a mean age of 32.5 ± 4.5 years and median (interquartile range [IQR]) body mass index of 28.3 (26.6-31.2) kg/m . The intervention group had a longer sleep duration in late pregnancy (mean difference 17.1 minutes (95% confidence interval [CI] 0.5-33.7) and a higher proportion achieving optimum sleep duration of 7-9 h (54.3 vs. 42.9%, relative risk [RR] 1.28 (95% CI 1.01-1.62). In late pregnancy, sleep duration of <6 h was associated with lower breastfeeding rates on discharge (RR 0.74, 95% CI 0.57-0.95) and higher triglyceride levels (mean difference 0.24, 95% CI 0.10-0.38). There were no significant associations between sleep and incidence of gestational diabetes mellitus or pre-eclampsia/toxaemia, or other metabolic parameters assessed (insulin, fasting glucose, HOMA-IR).

CONCLUSION

A diet and exercise intervention from early pregnancy may promote longer and optimal sleep duration, with maternal benefits such as lower triglyceride levels and higher breastfeeding rates.

摘要

目的

研究孕期产前饮食和运动干预对睡眠时长的影响。作为次要目标,评估了睡眠时长与妊娠体重增加(GWG)、产妇代谢参数和妊娠结局之间的关系。

设计

二次分析。

地点

爱尔兰都柏林的一家大型三级妇产医院。

人群

2013 年 3 月至 2016 年 8 月期间参加妊娠运动与营养研究(PEARS)随机对照试验的 326 名超重或肥胖女性。

方法

随机试验的二次分析。

主要观察指标

PEARS 干预对睡眠时长的影响,以及睡眠时长与产妇代谢参数和妊娠结局的关系。

结果

参与者的平均年龄为 32.5±4.5 岁,中位数(四分位间距 [IQR])体重指数为 28.3(26.6-31.2)kg/m。干预组在妊娠晚期的睡眠时长更长(平均差异 17.1 分钟[95%置信区间(CI)0.5-33.7]),并且有更高比例达到 7-9 小时的最佳睡眠时长(54.3%比 42.9%,相对风险[RR]1.28[95%CI1.01-1.62])。在妊娠晚期,<6 小时的睡眠时长与较低的产后母乳喂养率(RR0.74,95%CI0.57-0.95)和较高的甘油三酯水平(平均差异 0.24,95%CI0.10-0.38)相关。睡眠时长与妊娠期糖尿病或先兆子痫/子痫的发生率或其他代谢参数(胰岛素、空腹血糖、HOMA-IR)之间没有显著关联。

结论

从妊娠早期开始的饮食和运动干预可能会促进更长和更理想的睡眠时长,从而带来降低甘油三酯水平和提高母乳喂养率等产妇益处。

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