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首页> 外文期刊>BMC Pregnancy and Childbirth >Effectiveness of a normative nutrition intervention (diet, physical activity and breastfeeding) on maternal nutrition and offspring growth: the Chilean maternal and infant nutrition cohort study (CHiMINCs)
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Effectiveness of a normative nutrition intervention (diet, physical activity and breastfeeding) on maternal nutrition and offspring growth: the Chilean maternal and infant nutrition cohort study (CHiMINCs)

机译：规范性营养干预（饮食，体育锻炼和母乳喂养）对孕产妇营养和后代生长的有效性：智利孕产妇和婴儿营养队列研究（CHiMINC）

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Background Maternal obesity before and during pregnancy predicts maternal and infant risks of obesity and its associated metabolic conditions. Dietary and physical activity recommendations during pregnancy as well as weight monitoring are currently available in the Chilean primary health care system. However some of these recommendations are not updated and most of them are poorly implemented. We seek to assess the effectiveness of an intervention that enhances the implementation of updated nutrition health care standards (diet, physical activity, and breastfeeding promotion) during pregnancy on maternal weight gain and infant growth. Methods Design & Setting: Cluster randomized controlled trial. The cluster units will be 12 primary health care centers from two counties (La Florida and Puente Alto) from the South-East Area of Santiago randomly allocated to: 1) enhanced nutrition health care standards (intervention group) or 2) routine care (control group). Participants: Women seeking prenatal care before 15?weeks of gestation, residing within a catchment area of selected health centers, and who express that they are not planning to change residence will be invited to participate in the study. Pregnant women classified as high risk according to the Chilean norms (i.e age 40?years, multiple gestation, pre-gestational medical conditions, previous pregnancy-related issues) and/or underweight will be excluded. Intervention: Pregnant women who attend intervened health care centers starting at their first prenatal visit will receive advice regarding optimal weight gain during pregnancy and diet and physical activity counseling-support. Pregnant women who attend control health clinics will receive routine antenatal care according to national guidelines. We plan to recruit 200 women in each health center. Assuming a 20?% loss to follow up, we expect to include 960 women per arm. Main outcome measures: 1) Achievement of adequate weight gain based on IOM 2009 recommendations and adequate glycaemic control at 24-28 weeks of pregnancy according to ADA 2011, and 2) healthy infant growth during the first year of age based on WHO standards. Discussion We expect that the intervention will benefit the participants in achieving adequate weight gain & metabolic control during pregnancy as well as adequate infant growth as a result of an increased impact of standard nutrition and health care practices. Gathered information should contribute to a better understanding of how to develop effective interventions to halt the maternal obesity epidemic and its associated co-morbidities in the Chilean population. Trial registration Clinicaltrials.gov Identifier: NCT01916603
机译：背景技术孕妇在怀孕之前和怀孕期间的肥胖状况可预测孕妇和婴儿肥胖的风险及其相关的代谢状况。智利初级卫生保健系统目前提供有关怀孕期间饮食和身体活动的建议以及体重监测。但是，其中一些建议未更新，并且大多数建议执行不力。我们力图评估一项干预措施的有效性，该干预措施在孕妇孕期增加体重和婴儿生长的过程中，加强执行更新的营养保健标准（饮食，体育锻炼和母乳喂养）。方法设计与设置：聚类随机对照试验。集群单位将是圣地亚哥东南地区两个县（拉弗罗里达州和普恩特奥多）的12个初级卫生保健中心，随机分配给：1）加强营养保健标准（干预组）或2）常规保健（控制）组）。参加者：将邀请妇女在妊娠15周之前接受产前检查，居住在选定医疗中心的集水区内，并表示不打算搬家的妇女参加研究。根据智利规范（即40岁以下，多胎妊娠，孕前医疗状况，先前与怀孕有关的问题）和/或体重过轻，孕妇将被排除在高风险之外。干预措施：从首次产前检查开始就进入干预保健中心的孕妇将获得有关怀孕期间最佳体重增加以及饮食和身体活动咨询支持的建议。参加控制卫生所的孕妇将根据国家指南接受常规产前检查。我们计划在每个保健中心招募200名妇女。假设要追随20％的损失，我们预计每臂将包括960名女性。主要结局指标：1）根据ADA 2011，根据IOM 2009的建议获得足够的体重增加，并在妊娠24-28周时达到足够的血糖控制，以及2）根据WHO的标准，在第一岁婴儿的健康成长。讨论我们希望，由于标准营养和保健习惯的影响增加，干预措施将使参加者在怀孕期间实现适当的体重增加和代谢控制以及婴儿充分生长，从而使参与者受益。收集到的信息应有助于更好地了解如何制定有效的干预措施，以制止智利人口中的孕产妇肥胖病及其相关的合并症。试用注册Clinicaltrials.gov标识符：NCT01916603

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