Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial

作者：Bruno Raffaele; Petrella Elisabetta; Bertarini Valentina; Pedrielli Giulia; Neri Isabella; Facchinetti Fabio

来源：Maternal and Child Nutrition, 2017, 13(3): e12333.

DOI：10.1111/mcn.12333

• obesity
• pregnancy and nutrition
• diabetes
• fetal growth
• pregnancy outcome
• physical activity

This study aims to determine whether the prescription of a detailed lifestyle programme in overweight/obese pregnant women influences the occurrence of gestational diabetes (GDM), and if this kind of prescription increases the adherence to a healthier lifestyle in comparison to standard care. The study was designed as a randomized controlled trial, with open allocation, enrolling women at 9-12weeks of pregnancy with a BMI25kg/m(2). The women assigned to the Intervention group (I=96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations. Those assigned to the Standard Care group (SC=95) received lifestyle advices regarding healthy nutrition and exercise. Follow-up was planned at the 16(th), 20(th), 28(th) and 36(th) weeks. A total of 131 women completed the study (I=69, SC=62). The diet adherence was higher in the I (57.9%) than in the SC (38.7%) group. GDM occurred less frequently in the I (18.8%) than in the SC (37.1%, P=0.019) group. The adherent women from either groups showed a lower GDM rate (12.5% vs. 41.8%, P <0.001). After correcting for confounders, the GDM rate was explained by allocation into the I group (P=0.034) and a lower BMI category (P=0.039). The rates of hypertension, preterm birth, induction of labour, large for gestational age babies and birthweight>4000g were significantly lower in I group. The incidence of small for gestational age babies was not different. These findings demonstrate that the adherence to a personalized, hypocaloric, low-glycaemic, low-saturated fat diet started early in pregnancy prevents GDM occurrence, in women with BMI25kg/m(2).

• 出版日期2017-7