Weight management for improved pregnancy outcomes

体重管理可改善妊娠结局

• 批准号: 8278607
• 负责人: Victor J Stevens
• 金额: $ 36.49万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-12 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8278607
• 关键词: Address; Adoption; Adverse effects; Age; Applied Research; Benefits and Risks; Birth; Birth Weight; Birth trauma; Body Weight Changes; Body mass index; Caring; Cesarean section; Data; Developed Countries; Development; Diabetes Mellitus; Diet; Discipline of obstetrics; Eating; Energy Intake; Epidemic; Equilibrium; Fetal Growth; Fetal Macrosomia; Fetus; First Pregnancy Trimester; Future; Gestational Age; Gestational Diabetes; Goals; Health; High birth weight infant; Hypertension; Infant; Institute of Medicine (U.S.); Intake; Intervention; Lead; Long-Term Effects; Low Prevalence; Managed Care; Measures; Medical; Morbid Obesity; Morbidity - disease rate; Mothers; National Institute of Diabetes and Digestive and Kidney Diseases; Neonatal; Newborn Infant; Nutritional; Obesity; Outcome; Outcome Assessment; Outcome Measure; Overweight; Participant; Patients; Population; Postoperative Complications; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Prevalence; Public Health; Randomized; Recommendation; Recruitment Activity; Research; Risk; Safety; Specific qualifier value; Spontaneous abortion; Testing; Treatment Efficacy; Ultrasonography; Underweight; United States; United States National Institutes of Health; Vaginal delivery procedure; Weight; Weight Gain; Weight maintenance regimen; Woman; aged; design; follow-up; group intervention; improved; infant death; interest; member; mortality; neonate; nutrition; prevent; primary outcome; programs; reproductive; satisfaction; secondary outcome; stillbirth; treatment as usual; volunteer; weight maintenance

ABSTRACT: Historically, under nutrition has been a major health concern. Recently however, over nutrition has also become a serious public health problem in the United States and other industrialized countries. With the new obesity epidemic we see increasing morbidity, mortality, and public health burden, particularly among reproductive-aged women. Whereas morbid obesity was once rare among pregnant women, a rapidly increasing proportion of obstetrics patients now have levels of obesity which dramatically increase their risk of serious pregnancy complications. These complications include increased risk of miscarriage, stillbirth, having a fetus that is too large leading to cesarean section or birth injuries for mom and baby from vaginal delivery, and death of the infant in the newborn period. More than 1/3 of women in the U.S. are now starting their pregnancies with a body mass index or 30 or greater, a condition that was unusual to rare 50 years ago. Given the serious consequences of added weight gain during pregnancy for obese women, such as gestational diabetes, pre-eclampsia, or cesarean delivery, the best strategy during their pregnancy may be to maintain a steady weight rather than gaining 15 pounds or more. Unfortunately, there is little research on the efficacy and feasibility of minimizing weight gain during pregnancy. This study is designed to address that problem. Two hundred women with BMIs of 30 or greater at the start of their pregnancy will be recruited for this feasibility test. All participants will be members of a non-profit managed care organization that provides high-quality obstetrics care. Patients who volunteer to participate will be randomly assigned to either a weight maintenance intervention or to usual care. Participants assigned to the intervention will participate in a weight maintenance program designed to help them eat a nutritionally balanced diet and to also control energy intake to minimize weight gain during their pregnancy. Participants (and their babies) in both groups will participate in follow- up assessments at 2 weeks postpartum, 6 months postpartum and one year postpartum. The primary outcome measures will be mothers' weight gain during pregnancy, the amount of weight retained after delivery, and the proportion of large for gestational age infants. Secondary outcomes will include multiple safety measures of the mothers and their babies. In addition to measures of safety, our secondary analyses will address the feasibility and acceptability of a weight management intervention among obese pregnant women.

摘要：从历史上看，在营养下一直是健康问题。但是最近， 在美国和其他 工业化国家。随着新的肥胖流行，我们看到发病率，死亡率增加， 和公共卫生负担，尤其是在生殖妇女中。而病态 肥胖曾经在孕妇中很少见，妇产病的比例迅速增加 现在，患者的肥胖水平会大大增加严重怀孕的风险 并发症。这些并发症包括增加流产的风险，死产，患有 胎儿太大，导致剖宫产或妈妈和婴儿的出生受伤 阴道分娩和婴儿在新生时期的死亡。超过1/3的女性 美国现在正在使用体重指数或30或更高的情况开始怀孕，这种情况是 50年前很少见。考虑到增加体重增加的严重后果 在怀孕期间，肥胖妇女（例如妊娠糖尿病，前宾夕化或剖宫产） 交付，怀孕期间最好的策略可能是保持体重稳定 比增加15磅或更多。不幸的是，关于功效和 在怀孕期间减少体重增加的可行性。这项研究旨在解决 问题。在怀孕开始时，有200名BMI 30岁或更高的妇女将是 为此可行性测试招募。所有参与者将是非营利管理护理的成员 提供高质量的妇产科护理的组织。自愿参加的患者将 随机分配给体重维持干预措施或通常的护理。参与者 分配给干预措施将参加旨在帮助的体重维护计划 他们吃营养平衡的饮食，并控制能量摄入以最大程度地减少体重增加 在怀孕期间。两组的参与者（及其婴儿）将参与后续 在产后2周，产后6个月和产后一年的评估。这 主要结局指标将是母亲在怀孕期间的体重增加，体重的量 分娩后保留，胎龄大的比例。次要 结果将包括母亲及其婴儿的多种安全措施。此外 安全措施，我们的次要分析将解决 肥胖孕妇的体重管理干预。

项目成果

Validity of medical chart weights and heights for obese pregnant women.

• DOI: 10.13063/2327-9214.1051
• 发表时间: 2014
• 期刊: EGEMS (Washington, DC)
• 作者: Leo MC;Lindberg NM;Vesco KK;Stevens VJ
• 通讯作者: Stevens VJ

Healthy Moms, a randomized trial to promote and evaluate weight maintenance among obese pregnant women: study design and rationale.

• DOI: 10.1016/j.cct.2012.03.006
• 发表时间: 2012-07
• 期刊: Contemporary clinical trials
• 影响因子: 2.2
• 作者: Vesco KK;Karanja N;King JC;Gillman MW;Perrin N;McEvoy C;Eckhardt C;Smith KS;Stevens VJ
• 通讯作者: Stevens VJ

One-year postpartum outcomes following a weight management intervention in pregnant women with obesity.

• DOI: 10.1002/oby.21597
• 发表时间: 2016-10
• 期刊: OBESITY
• 影响因子: 6.9
• 作者: Vesco, Kimberly K.;Leo, Michael C.;Karanja, Njeri;Gillman, Matthew W.;McEvoy, Cindy T.;King, Janet C.;Eckhardt, Cara L.;Smith, K. Sabina;Perrin, Nancy;Stevens, Victor J.
• 通讯作者: Stevens, Victor J.