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一项基于家庭的产前行为治疗与营养和运动生活方式干预计划对出生时婴儿身长别体重的影响。

Impact of an Antenatal Family-based Behavioral Treatment with a Nutrition and Exercise Lifestyle Intervention Program on Infant Weight-for-length at Birth.

作者信息

Hubbard Madeline E, Ruchat Stephanie-May, Davenport Margie H, Prapavessis Harry, Gratton Robert, McManus Ruth, Giroux Isabelle, Hanley Anthony J, Mottola Michelle F

机构信息

R. Samuel McLaughlin Foundation- Exercise and Pregnancy Laboratory, Western University, London, ON, Canada.

School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.

出版信息

Int J Behav Med. 2025 Jan 6. doi: 10.1007/s12529-024-10345-8.

Abstract

BACKGROUND

World Health Organization (WHO) growth standards, including weight-for-length, are used to monitor infant size. Excessive infant weight-for-length at or above the 85th percentile is a risk for childhood overweight. Although antenatal interventions like the nutrition and exercise lifestyle intervention program (NELIP) have successfully prevented excessive gestational weight gain, strategies to improve the intervention remain of interest. This study investigated the impact of adding a family-based behavioral treatment (FBBT) to NELIP on infant weight-for-length at birth based on WHO growth standards and gestational weight gain.

METHODS

Participants were recruited for the NELIP group (n = 68), followed by the NELIP + FBBT group (n = 48). In addition to full analyses, a subgroup of NELIP (n = 48) was matched to NELIP + FBBT based on pre-pregnancy BMI, parity and age.

RESULTS

The number of infants with excessive weight-for-length at birth was significantly different between the NELIP + FBBT and the full NELIP group when maternal pre-pregnancy BMI was considered (φ = .275; p = .032). Significantly fewer infants had weight-for-length at or above the 85th percentile in the NELIP + FBBT group (29.2%) compared to the matched NELIP group (50.0%) with a medium effect size (φ = .213; p = .037). There were no significant differences between groups in any measures of maternal gestational weight gain.

CONCLUSIONS

The inclusion of a FBBT improved the effectiveness of a NELIP by decreasing the prevalence of excessive infant weight-for-length at birth, especially in participants with pre-pregnancy obesity, which could have implications on future childhood overweight and obesity.

CLINICALTRIALS

gov identifier: NCT01129505.

摘要

背景

世界卫生组织(WHO)的生长标准,包括身长别体重,用于监测婴儿体格发育情况。婴儿身长别体重超过第85百分位数属于儿童期超重风险因素。尽管诸如营养与运动生活方式干预项目(NELIP)等产前干预措施已成功预防了孕期体重过度增加,但仍需探索改进干预措施的策略。本研究基于WHO生长标准及孕期体重增加情况,探讨在NELIP基础上增加家庭行为治疗(FBBT)对婴儿出生时身长别体重的影响。

方法

招募受试者分为NELIP组(n = 68),之后是NELIP + FBBT组(n = 48)。除了进行全面分析外,根据孕前体重指数、产次和年龄,将NELIP组中的一个亚组(n = 48)与NELIP + FBBT组进行匹配。

结果

考虑孕妇孕前体重指数时,NELIP + FBBT组与整个NELIP组出生时身长别体重过高的婴儿数量存在显著差异(φ = 0.275;p = 0.032)。与匹配的NELIP组(50.0%)相比,NELIP + FBBT组身长别体重处于或高于第85百分位数的婴儿明显更少(29.2%),效应量中等(φ = 0.213;p = 0.037)。两组孕妇孕期体重增加的各项指标无显著差异。

结论

纳入FBBT可提高NELIP的有效性,降低出生时婴儿身长别体重过高的发生率,尤其是对于孕前肥胖的参与者,这可能对未来儿童期超重和肥胖产生影响。

临床试验

美国国立医学图书馆临床试验注册中心标识符:NCT01129505

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