Wagner Kathryn A, Whitcomb Brian W, Marcus Bess, Pekow Penelope, Rosal Milagros C, Leidy Sievert Lynnette, Tucker Katherine L, Manson JoAnn E, Chasan-Taber Lisa
Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, United States of America.
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America.
Prev Med Rep. 2024 Jan 28;38:102633. doi: 10.1016/j.pmedr.2024.102633. eCollection 2024 Feb.
To evaluate the effect of a culturally-modified, motivationally-targeted, individually-tailored lifestyle intervention on postpartum weight retention among Hispanic women with overweight/obesity.
Proyecto Mamá was a randomized controlled trial conducted in western Massachusetts (2014-2020). Hispanic women with overweight/obese pre-pregnancy BMI (n = 148) were randomized in early pregnancy to a Lifestyle Intervention (LI) or a Health & Wellness (HW) comparison arm. The LI was based upon theoretical concepts, used a low-cost, high-reach strategy, and focused on healthy exercise and diet with follow-up through 12-months postpartum. The primary outcome of change in weight was calculated as the difference between pre-pregnancy weight and 6-week, 6-month, and 12-month postpartum weight. The secondary outcome was achievement of 5 % weight reduction from pre-pregnancy weight. Retention was 68.2 % in the overall postpartum period and 31.0 % at 12-months.
In intent-to-treat analyses, compared to the HW arm, there was no difference in postpartum weight retention at 6-weeks (0.0 kg, 95 % CI: -3.4, 3.5), 6-months (-1.8 kg, 95 % CI: -5.6, 2.0), or 12-months (-2.0 kg, 95 % CI: -7.0, 3.1). In a secondary complete case analysis, compared to the HW arm, the LI arm had 5.5 times higher odds of meeting the postpartum weight reduction goal (aOR = 5.5, 95 % CI: 1.7, 17.9) adjusting for pre-pregnancy weight.
A lifestyle intervention among at-risk Hispanic women with overweight/obesity had no overall impact on postpartum weight, but a beneficial impact among those who completed the trial. Future studies should focus on increasing the feasibility and acceptability of the intervention in this at-risk population.
评估一种经过文化调整、以动机为导向、个性化定制的生活方式干预措施对超重/肥胖的西班牙裔女性产后体重滞留的影响。
“妈妈项目”是在马萨诸塞州西部进行的一项随机对照试验（2014 - 2020年）。孕前BMI超重/肥胖的西班牙裔女性（n = 148）在怀孕早期被随机分为生活方式干预组（LI）或健康与保健对照组（HW）。生活方式干预基于理论概念，采用低成本、高覆盖策略，重点关注健康锻炼和饮食，并持续跟踪至产后12个月。体重变化的主要结局计算为孕前体重与产后6周、6个月和12个月体重之间的差值。次要结局是与孕前体重相比体重减轻5%。产后总体留存率为68.2%，12个月时为31.0%。
在意向性分析中，与健康与保健对照组相比，产后6周（0.0千克，95%可信区间：-3.4，3.5）、6个月（-1.8千克，95%可信区间：-5.6，2.0）或12个月（-2.0千克，95%可信区间：-7.0，3.1）的体重滞留情况无差异。在二次完全病例分析中，与健康与保健对照组相比，调整孕前体重后，生活方式干预组实现产后体重减轻目标的几率高5.5倍（调整后比值比 = 5.5，95%可信区间：1.7，17.9）。
对有超重/肥胖风险的西班牙裔女性进行的生活方式干预对产后体重没有总体影响，但对完成试验的女性有有益影响。未来的研究应专注于提高该干预措施在这一高危人群中的可行性和可接受性。
