The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial

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• 作者：Jodie M Dodd ; Andrew J McPhee ; Deborah Turnbull ; Lisa N Yelland…
• 关键词：Pregnancy ; Overweight and obesity ; Neonatal health ; Randomised trial ; Dietary and lifestyle intervention
• 刊名：BMC Medicine
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：12
• 期：1
• 全文大小：1,031 KB
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• 刊物主题：Medicine/Public Health, general; Biomedicine general;
• 出版者：BioMed Central
• ISSN：1741-7015

文摘

Background Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese. Methods We report a range of pre-specified secondary neonatal outcomes from a large randomised trial in which antenatal dietary and lifestyle advice was provided to women who were overweight or obese. Pregnant women were eligible for participation with a body mass index of 25?kg/m2 or over, and singleton gestation between 10+0 and 20+0?weeks. Outcome measures included gestational age at birth; Apgar score below 7 at 5?minutes of age; need for resuscitation at birth; birth weight above 4.5?kg or below 2.5?kg; birth weight, length and head circumference (and Z-scores); admission to the nursery; respiratory distress syndrome; and postnatal length of stay. Data relating to the primary outcome (large for gestational age infants defined as birth weight above the 90th centile) and birth weight above 4?kg have been reported previously. Analyses used intention-to-treat principles. Results In total, 2,142 infants were included in the analyses. Infants born to women following lifestyle advice were significantly less likely to have birth weight above 4.5?kg (2.15% versus 3.69%; adjusted risk ratio (aRR)--.59; 95% confidence interval (CI) 0.36 to 0.98; P--.04), or respiratory distress syndrome (1.22% versus 2.57%; aRR--.47; 95% CI 0.24 to 0.90; P--.02), particularly moderate or severe disease, and had a shorter length of postnatal hospital stay (3.94?±-.26?days versus 4.41?±-.87?days; adjusted ratio of means 0.89; 95% CI 0.82 to 0.97; P--.006) compared with infants born to women who received Standard Care. Conclusions For women who are overweight or obese, antenatal dietary and lifestyle advice has health benefits for infants, without an increase in the risk of harm. Continued follow-up into childhood will be important to assess the longer-term effects of a reduction in high infant birth weight on risk of child obesity. Please see related articles: http://www.biomedcentral.com/1741-7015/12/161 and http://www.biomedcentral.com/1741-7015/12/201. Clinical trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426)