Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA.
Evaluation Sciences Unit, Division of Primary Care Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Child Obes. 2023 Dec;19(8):515-524. doi: 10.1089/chi.2022.0137. Epub 2022 Nov 11.
Rapid weight gain during infancy is associated with risk for later obesity, yet little research to date has examined the effect of a responsive parenting (RP) intervention with care coordination between pediatric primary care providers and Women, Infants, and Children nutritionists on infant weight. The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study is a pragmatic, randomized clinical trial for mothers and infants ( = 288) designed to examine the effect of a patient-centered RP intervention that used advanced health information technology strategies to coordinate care to reduce rapid infant weight gain compared with standard care. General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age scores [ = -0.04, standard error (SE) = 0.04 vs. = 0.05, SE = 0.04; = 0.008] and lower mean BMI ( = 16.05, SE = 0.09 vs. = 16.24, SE = 0.09; = 0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [ difference = -0.32, standard deviation (SD) = 0.81 vs. 0.00, SD = 0.90; = 0.01]. This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe. clinicaltrials.gov identifier: NCT03482908.
婴儿期体重快速增加与日后肥胖风险相关，但迄今为止，很少有研究探讨儿科初级保健提供者与妇女、婴儿和儿童营养学家之间进行响应式育儿 (RP) 干预并协调护理对婴儿体重的影响。妇女、婴儿和儿童强化早期健康生活方式促进婴儿（WEE Baby Care）研究是一项针对母亲和婴儿的实用随机临床试验（ = 288），旨在检验一种以患者为中心的 RP 干预的效果，该干预使用先进的健康信息技术策略来协调护理，以降低婴儿体重快速增加的速度，与标准护理相比。使用一般线性模型，从出生到 6 个月，研究了干预对婴儿条件体重增长评分、体重-年龄评分、BMI 和超重状态（BMI-年龄≥第 85 百分位）的影响，以及母亲从 2 至 6 个月时使用食物安抚婴儿的情况。干预对 6 个月时婴儿的条件体重增长评分或超重状态没有影响。RP 干预组婴儿的平均体重-年龄评分较低 [ = -0.04，标准误差 (SE) = 0.04 与 = 0.05，SE = 0.04； = 0.008]，平均 BMI 也较低 [ = 16.05，SE = 0.09 与 = 16.24，SE = 0.09； = 0.03]，与标准护理相比。从 2 至 6 个月时，RP 干预组母亲使用基于情绪的食物来安抚婴儿的情况少于标准护理组 [差异 = -0.32，标准差 (SD) = 0.81 与 0.00，SD = 0.90； = 0.01]。这项实用的、以患者为中心的 RP 干预并没有降低婴儿体重快速增加或超重的速度，但与婴儿 BMI 略有降低和母亲使用基于情绪的食物来安抚婴儿的情况减少有关。临床试验标识符：NCT03482908。
