Kemp Bridie J, Kelly Bronagh, Cupples Georgina, Fleck Olwen, McAuley Emma, Creighton Rachel M, Wallace Helen, Graham Una, Mulligan Ciara, Kennedy Adele, Patterson Chris C, McCance David R
Regional Centre for Endocrinology and Diabetes, Royal Jubilee Maternity Centre, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK.
Diabetes & Endocrinology, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast BT16 1RH, UK.
J Endocr Soc. 2024 Sep 11;8(10):bvae151. doi: 10.1210/jendso/bvae151. eCollection 2024 Aug 27.
This study examined the influence of a pregnancy and postnatal multicomponent lifestyle intervention for women with gestational diabetes mellitus (GDM) and overweight/obesity from 6 weeks to 12 months postnatal. The primary outcome was weight at 12 months. Secondary outcomes included change in body mass index (BMI), waist circumference (WC) and fasting plasma glucose (FPG).
The study involved 235 pregnant women with GDM and BMI ≥ 25 kg/m during pregnancy. Intervention components included an educational session, activity tracker (Fitbit), monthly phone calls, weekly motivational text messages, 12-week voucher for a commercial weight management organization and anthropometric, biochemical, and clinical measurements taken at 6 weeks, 6 months, and 12 months postnatal. The control group received routine local maternity care.
A mean weight change of -2.0 (SD 7.1) kg was observed in the intervention group compared with -0.6 (SD 8.0) kg in the control group, difference -1.4 (95% CI -4.4, 1.5) kg from 6 weeks to 12 months postnatal, but this was not statistically significant ( = .34). Neither were significant differences obtained for any secondary outcomes: BMI -0.6 (-1.6, 0.5) kg/m, WC -1.0 (-5.1, 3.2) cm and FPG 0.07 (-0.15, 0.29) mmol/L.
This lifestyle intervention among women with overweight/obesity and GDM resulted in a statistically nonsignificant 1.4 kg greater weight loss compared with routine care at 12 months postnatal. Further research is needed to understand how the different components of this lifestyle intervention might be better applied to elicit more successful results.
本研究探讨了针对妊娠糖尿病（GDM）且超重/肥胖的女性，在产后6周 至12个月进行的孕期及产后多成分生活方式干预的影响。主要结局是产后12个月时的体重。次要结局包括体重指数（BMI）、腰围（WC）和空腹血糖（FPG）的变化。
本研究纳入了235名孕期患有GDM且BMI≥25 kg/m²的孕妇。干预内容包括一次教育课程、活动追踪器（Fitbit）、每月电话随访、每周激励短信、商业体重管理机构的12周代金券，以及在产后6周、6个月和12个月进行人体测量、生化和临床指标检测。对照组接受常规的当地产科护理。
干预组平均体重变化为-2.0（标准差7.1）kg，而对照组为-0.6（标准差8.0）kg，产后6周 至12个月的差异为-1.4（95%置信区间-4.4，1.5）kg，但这无统计学意义（P = 0.34）。任何次要结局均无显著差异：BMI为-0.6（-1.6，0.5）kg/m²，WC为-1.0（-5.1，3.2）cm，FPG为0.07（-0.15，0.29）mmol/L。
与常规护理相比，这种针对超重/肥胖且患有GDM的女性的生活方式干预，在产后12个月时体重减轻了1.4 kg，但无统计学意义。需要进一步研究以了解这种生活方式干预的不同组成部分如何能更好地应用以获得更成功的结果。
