Owolabi Eyitayo O, Mbe Kougang Anne, Clancy Stephen L, Anthony Renaisa, Guo Yuqing
Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA.
BMC Pregnancy Childbirth. 2025 May 19;25(1):590. doi: 10.1186/s12884-025-07490-7.
Cardiometabolic disorders among childbearing women, particularly Black American women, contribute to adverse perinatal outcomes and long-term health consequences. Lifestyle interventions are critical approaches to improve cardiometabolic health.
This integrative review synthesized evidence on lifestyle interventions promoting cardiometabolic health among Black women of childbearing age in the U.S.
A comprehensive search strategy was developed and applied across PubMed, CINAHL, the Web of Science Core Collection, and Scopus from the databases' inception through August 2023. Key inclusion criteria were Black American women of childbearing age, lifestyle interventions using an experimental/quasi-experimental design conducted in the U.S., and cardiometabolic, health behavior, or psychosocial outcomes.
Thirty-three studies were included, with 29 (87%) using randomized controlled trials. Lifestyle interventions were primarily implemented during pregnancy and/or postpartum periods, only two in pre-pregnancy stage. Health education (i.e. structured/unstructured teaching on various lifestyle content) was the main intervention component. While many studies incorporated digital health technologies, only six leveraged mhealth tools (e.g., mobile health applications, internet-based platforms, social media) as the primary delivery method. Weight change was the most common cardiometabolic outcome, with five out of 13 studies showing significant reductions in gestational weight gain or postpartum weight retention. Of seven studies measuring other cardiometabolic outcomes (e.g., blood glucose), only one showed a significantly decreased incidence of hypertension. Three of 11 studies reported a significant increase in physical activity, and four out of ten showed significant improvement in dietary behaviors. Nine of the 15 studies measuring psychosocial outcomes found significant improvement, with five noting decreased depression. Common weaknesses included recruitment challenges, convenience sampling, small sample sizes, high attrition rates, and short post-intervention follow-up. Some studies adopting digital health technologies reported better retention rates and higher engagement.
The results suggest the potential impact of lifestyle interventions on weight reduction, increased physical activity, healthier dietary behaviors, and decreased depression. Future high-quality and powered studies are needed to investigate the efficacy of lifestyle interventions on cardiometabolic outcomes in this population by considering the use of digital health technologies to improve intervention recruitment, engagement and retention, including Black American women of childbearing age representing all socioeconomic levels, and targeting the pre-pregnancy stage.
育龄妇女，尤其是美国黑人妇女的心脏代谢紊乱会导致不良围产期结局和长期健康后果。生活方式干预是改善心脏代谢健康的关键方法。
本整合性综述综合了关于促进美国育龄黑人妇女心脏代谢健康的生活方式干预的证据。
制定了全面的检索策略，并应用于从数据库创建到2023年8月的PubMed、CINAHL、科学引文索引核心合集和Scopus数据库。关键纳入标准为美国育龄黑人妇女、在美国进行的采用实验性/准实验性设计的生活方式干预，以及心脏代谢、健康行为或心理社会结局。
纳入了33项研究，其中29项（87%）采用随机对照试验。生活方式干预主要在孕期和/或产后实施，只有两项在孕前阶段实施。健康教育（即关于各种生活方式内容的结构化/非结构化教学）是主要的干预组成部分。虽然许多研究纳入了数字健康技术，但只有六项将移动健康工具（如移动健康应用程序、基于互联网的平台、社交媒体）作为主要传播方式。体重变化是最常见的心脏代谢结局，13项研究中有5项显示孕期体重增加或产后体重滞留显著减少。在测量其他心脏代谢结局（如血糖）的7项研究中，只有1项显示高血压发病率显著降低。11项研究中有3项报告身体活动显著增加，10项研究中有4项显示饮食行为有显著改善。在测量心理社会结局的15项研究中有9项发现有显著改善，其中5项指出抑郁有所减轻。常见的弱点包括招募挑战、方便抽样、样本量小、损耗率高以及干预后随访时间短。一些采用数字健康技术的研究报告了更高的保留率和参与度。
结果表明生活方式干预对减轻体重、增加身体活动、形成更健康的饮食行为以及减轻抑郁有潜在影响。未来需要高质量且有足够样本量的研究，通过考虑使用数字健康技术来改善干预的招募、参与度和保留率，以调查生活方式干预对该人群心脏代谢结局的疗效，包括代表所有社会经济水平的美国育龄黑人妇女，并针对孕前阶段。
