McGill Bronwyn, Lees Dominic, Salisbury Justine, Reynolds Tahlia, Davidson Sandy, Dorney Edwina, Jeong Sarah Yeun-Sim, O'Hara Blythe J
Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia.
Biostatistics Training Program, NSW Ministry of Health, St Leonards, NSW 2065, Australia.
Healthcare (Basel). 2023 Aug 29;11(17):2414. doi: 10.3390/healthcare11172414.
The efficacy of lifestyle interventions for reduced gestational weight gain (GWG) is established, but evidence of their effectiveness is limited. The Get Healthy in Pregnancy (GHiP) program is a telephone health coaching program supporting healthy GWG delivered state-wide in New South Wales, Australia. This evaluation explores the impact of GHiP on behavioural outcomes and GWG, analysing GHiP participant data (n = 3702 for 2018-2019). We conducted McNamar's tests to explore within-individual change for behavioural outcomes and logistic regression to assess associations between demographic characteristics, participant engagement and behavioural and weight outcomes for women who completed the program. Participants who completed ten coaching calls made significant improvements (all < 0.001) in more health-related behaviours (walking, vigorous physical activity, vegetable consumption, takeaway meals and sweetened drink consumption) than those who completed fewer calls. Among women with valid weight change data (n = 245), 31% gained weight below, 33% gained weight within, and 36% gained weight above GWG guidelines. Pre-pregnancy BMI was the only factor significantly associated with meeting GWG guidelines. Women with pre-pregnancy overweight and obesity had lower odds than those with a healthy weight of having GWG within the guidelines. The majority of these women did not gain weight above the guidelines. A higher proportion of women with pre-pregnancy obesity gained weight below the guidelines (33.8%) than above the guidelines (28.5%). GHiP has the potential to support all pregnant women, including those with pre-pregnancy obesity, to achieve a healthier pregnancy.
生活方式干预对减少孕期体重增加(GWG)的效果已得到证实,但其有效性的证据有限。“孕期健康计划”(GHiP)是一项电话健康指导计划,在澳大利亚新南威尔士州全州范围内提供,以支持健康的孕期体重增加。本评估探讨了GHiP对行为结果和孕期体重增加的影响,分析了GHiP参与者的数据(2018 - 2019年为3702例)。我们进行了麦克纳马尔检验,以探讨行为结果的个体内变化,并进行逻辑回归分析,以评估完成该计划的女性的人口统计学特征、参与者参与度与行为和体重结果之间的关联。完成十次指导电话的参与者在更多与健康相关的行为(步行、剧烈体育活动、蔬菜消费、外卖餐食和含糖饮料消费)方面比完成电话次数较少的参与者有显著改善(均P<0.001)。在有有效体重变化数据的女性(n = 245)中,31%的人体重增加低于、33%的人体重增加在、36%的人体重增加高于孕期体重增加指南。孕前BMI是与符合孕期体重增加指南显著相关的唯一因素。孕前超重和肥胖的女性符合孕期体重增加指南的几率低于体重正常的女性。这些女性中的大多数体重增加未超过指南。孕前肥胖的女性体重增加低于指南的比例(33.8%)高于高于指南的比例(28.5%)。GHiP有潜力支持所有孕妇,包括孕前肥胖的孕妇,实现更健康的孕期。