Jacobson Lisette T, Befort Christie, Okut Hayrettin, Zackula Rosey, Dowling Jolynn, Stern Judy E, Robbins David C, Wolfe Michael D, Kluding Patricia, Grainger David A
University of Kansas School of Medicine-Wichita, Department of Population Health, Department of Obstetrics and Gynecology, Wichita, Kansas, USA.
University of Kansas Medical Center-Kansas City, Department of Population Health, Kansas City, Kansas, USA.
J Hum Lact. 2025 Feb;41(1):115-131. doi: 10.1177/08903344241297604. Epub 2024 Nov 26.
Globally, rising trends in gestational diabetes and body mass index contribute to maternal and neonatal morbidity and mortality. Lifestyle modifications and breastfeeding may reverse this effect, although few studies combine these into one intervention.
To measure postpartum weight retention, breastfeeding duration, hemoglobin A1C, and mean arterial blood pressure at 6 months postpartum among women with elevated pre-pregnancy body mass index.
The electronic Monitoring of Mom's Schedule study (eMOMS™) was a feasibility, three-arm, randomized controlled trial modeled after a Diabetes Prevention Program and breastfeeding support. A health coach delivered a 12-month virtual intervention. Study arm results were compared using Wilcoxon signed-ranks exact test reporting from a two-sided test and bootstrapped samples with 95% confidence intervals.
Between September 2019 and May 2021, 100 individuals were screened, and 35 were randomized: nine to Group 1, 14 to Group 2, and 12 to Group 3. At baseline, participants averaged 13.0 ( = 2.5) weeks gestation, with a mean pre-pregnancy body mass index of 29.7 ( = 3.0). With 5,000 bootstrapped samples, mean weight retention from baseline to 6 months postpartum was: 4.0 kg, 95% CI [1.6, 6.2] for Group 1; 3.7 kg, CI [-1.8, 9.8] for Group 2; and 7.5 kg, CI [4.1, 11.6] for Group 3. Mean (exclusive) breastfeeding duration was 9.3 weeks, 95% CI [0.43, 26.1]; 9.6 weeks, CI [4.4, 15.7]; and 15.1 weeks, CI [6.5, 23.3] for each group, respectively.
Our intervention was positively associated with postpartum weight retention and breastfeeding duration. Future research is needed to assess intervention components.
在全球范围内,妊娠期糖尿病和体重指数呈上升趋势,这导致了孕产妇和新生儿的发病率和死亡率。生活方式的改变和母乳喂养可能会扭转这种影响,尽管很少有研究将这两者结合在一种干预措施中。
测量孕前体重指数升高的女性产后6个月时的体重保留情况、母乳喂养持续时间、糖化血红蛋白和平均动脉血压。
妈妈日程电子监测研究(eMOMS™)是一项可行性、三臂、随机对照试验,以糖尿病预防计划和母乳喂养支持为蓝本。一名健康教练提供为期12个月的虚拟干预。使用Wilcoxon符号秩精确检验对研究组结果进行比较,该检验报告来自双侧检验和具有95%置信区间的自抽样样本。
在2019年9月至2021年5月期间,筛查了100人,35人被随机分组:9人分到第1组,14人分到第2组,12人分到第3组。在基线时,参与者的平均孕周为13.0(标准差=2.5)周,孕前平均体重指数为29.7(标准差=3.0)。通过5000个自抽样样本,从基线到产后6个月的平均体重保留情况为:第1组4.0千克,95%置信区间[1.6, 6.2];第2组3.7千克,置信区间[-1.8, 9.8];第3组7.5千克,置信区间[4.1, 11.6]。每组的平均(不包括)母乳喂养持续时间分别为9.3周,95%置信区间[0.43, 26.1];9.6周,置信区间[4.4, 15.7];15.1周,置信区间[6.5, 23.3]。
我们的干预与产后体重保留和母乳喂养持续时间呈正相关。需要进一步的研究来评估干预措施的各个组成部分。