背景:孕前和整个怀孕期间的营养干预已被提出作为促进后代健康出生后体重增加的方法,但很少有随机试验对此进行研究。
方法:在从出生到2岁的多个时间点,对576名妇女的后代进行了体重和身长的测量,这些妇女随机接受了孕前和产前含有肌醇的补充剂,益生菌,和额外的微量营养素(干预)或标准微量营养素补充剂(对照)。我们检查了2年时对年龄和性别标准化BMI的影响(世卫组织标准,调整研究地点,性别,产妇平价,吸烟和孕前BMI,和胎龄),随着体重的变化,长度,出生时的BMI,和使用潜在类增长分析的体重增加轨迹。
结果:在2年,干预后代的平均BMI有降低的趋势(调整后的平均差[aMD]-0.14SD[95%CI0.30,0.02],p=0.09),BMI>95百分位数(即>1.65标准差,9.2%vs18.0%,调整后风险比[ARR]0.51[95%CI0.31,0.82],p=0.006)。纵向数据显示,干预后代在生命的第一年体重快速增加>0.67SD的风险降低了24%(21.9%vs31.1%,RR0.76[95%CI0.58,1.00],p=0.047)。在生命的前2年中,持续体重增加>1.34SD的风险同样降低(7.7%vs17.1%,RR0.55[95%CI0.34,0.88],p=0.014)。从确定的五个体重增加轨迹中,从出生到2年,以0SD左右的稳定体重SDS为特征的“正常”体重增加轨迹中有更多的干预后代(38.8%vs30.1%,RR1.29[95%CI1.03,1.62],p=0.029)。
结论:补充肌醇,益生菌,和额外的微量营养素在孕前和怀孕期间降低了后代2年体重快速增加和肥胖的发生率。以前的报告表明,这些影响可能会转化为健康益处,但需要更长期的随访来评估这一点.
背景:ClinicalTrials.gov,NCT02509988(通用试验编号U1111-1171-8056)。2015年7月16日注册
Nutritional intervention preconception and throughout pregnancy has been proposed as an approach to promoting healthy postnatal weight gain in the offspring but few randomised trials have examined this.
Measurements of weight and length were obtained at multiple time points from birth to 2 years among 576 offspring of women randomised to receive preconception and antenatally either a supplement containing myo-inositol, probiotics, and additional micronutrients (intervention) or a standard micronutrient supplement (control). We examined the influence on age- and sex-standardised BMI at 2 years (WHO standards, adjusting for study site, sex, maternal parity, smoking and pre-pregnancy BMI, and gestational age), together with the change in weight, length, BMI from birth, and weight gain trajectories using latent class growth analysis.
At 2 years, there was a trend towards lower mean BMI among intervention offspring (adjusted mean difference [aMD] - 0.14 SD [95% CI 0.30, 0.02], p = 0.09), and fewer had a BMI > 95th percentile (i.e. > 1.65 SD, 9.2% vs 18.0%, adjusted risk ratio [aRR] 0.51 [95% CI 0.31, 0.82], p = 0.006). Longitudinal data revealed that intervention offspring had a 24% reduced risk of experiencing rapid weight gain > 0.67 SD in the first year of life (21.9% vs 31.1%, aRR 0.76 [95% CI 0.58, 1.00], p = 0.047). The risk was likewise decreased for sustained weight gain > 1.34 SD in the first 2 years of life (7.7% vs 17.1%, aRR 0.55 [95% CI 0.34, 0.88], p = 0.014). From five weight gain trajectories identified, there were more intervention offspring in the \"normal\" weight gain trajectory characterised by stable weight SDS around 0 SD from birth to 2 years (38.8% vs 30.1%, RR 1.29 [95% CI 1.03, 1.62], p = 0.029).
Supplementation with myo-inositol, probiotics, and additional micronutrients preconception and in pregnancy reduced the incidence of rapid weight gain and obesity at 2 years among offspring. Previous reports suggest these effects will likely translate to health benefits, but longer-term follow-up is needed to evaluate this.
ClinicalTrials.gov, NCT02509988 (Universal Trial Number U1111-1171-8056). Registered on 16 July 2015.