School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Lancet Glob Health. 2023 Mar;11 Suppl 1:S20. doi: 10.1016/S2214-109X(23)00103-1.
Adverse lifestyle factors in the periconception and early life period, including high maternal prepregnancy BMI and excessive gestational weight gain, are important risk factors for childhood obesity. Early prevention is key, but results from systematic reviews of preconception and pregnancy lifestyle interventions have shown mixed success in improving children's weight outcomes and adiposity. We aimed to investigate the complexity of these early interventions and process evaluation components and authors' statements to improve our understanding regarding their limited success.
We did a scoping review, guided by frameworks of the Joanna Briggs Institute and Arksey and O'Malley. Eligible articles (with no language restriction) were identified between July 11 and Sept 12, 2022, by searching PubMed, Embase, and CENTRAL; consulting previous reviews; and conducting CLUSTER searches. A thematic analysis was conducted with NVivo in which process evaluation components and authors' interpretations were coded as reasons. Intervention complexity was evaluated with the Complexity Assessment Tool for Systematic Reviews.
40 publications corresponding to 27 eligible preconception or pregnancy lifestyle trials with child data beyond age 1 month were included. Most interventions started during pregnancy (n=25) and focused on multiple lifestyle factors (eg, diet and exercise). The preliminary results show that almost no interventions involved the participants' partner or social network. Potential reasons for limited success in the interventions preventing overweight or obesity in children included the start time of the intervention, duration and intensity, and sample size or dropout rates. The results will be discussed with an expert group as part of a consultation stage.
The results and discussions with an expert group are expected to uncover gaps and inform the design or adaptation of future interventions and approaches to potentially increase success rates in preventing childhood obesity.
Funded by the Irish Health Research Board through the transnational JPI HDHL ERA-NET HDHL-INTIMIC-2020 call (PREPHOBES): EU Cofund action (number 727565; EndObesity project).
围孕期和生命早期的不良生活方式因素，包括孕妇孕前 BMI 较高和孕期体重过度增加，是儿童肥胖的重要危险因素。早期预防是关键，但孕前和孕期生活方式干预的系统评价结果表明，改善儿童体重和肥胖结果的效果喜忧参半。我们旨在研究这些早期干预措施的复杂性以及过程评估内容和作者的陈述，以提高我们对其有限成功的理解。
我们进行了一项范围综述，以 Joanna Briggs 研究所和 Arksey 和 O'Malley 的框架为指导。符合条件的文章（无语言限制）于 2022 年 7 月 11 日至 9 月 12 日通过搜索 PubMed、Embase 和 CENTRAL 确定，还咨询了之前的综述，并进行了 CLUSTER 搜索。使用 NVivo 进行了主题分析，其中对过程评估内容和作者的解释进行了编码作为原因。使用系统评价复杂性评估工具评估干预措施的复杂性。
共纳入 40 篇文献，涉及 27 项有 1 个月以上儿童数据的符合条件的孕前或孕期生活方式试验。大多数干预措施始于孕期（n=25），并侧重于多种生活方式因素（如饮食和运动）。初步结果表明，几乎没有干预措施涉及参与者的伴侣或社交网络。干预措施预防儿童超重或肥胖的效果有限的潜在原因包括干预开始时间、持续时间和强度以及样本量或辍学率。结果将作为磋商阶段的一部分与专家组讨论。
预计与专家组的讨论结果和讨论将揭示差距，并为未来干预措施的设计或调整提供信息，以提高预防儿童肥胖的成功率。
由爱尔兰健康研究委员会通过跨国 JPI HDHL ERA-NET HDHL-INTIMIC-2020 呼吁（PREPHOBES）资助：欧盟共同资助行动（第 727565 号；EndObesity 项目）。
