SwePub
Sök i LIBRIS databas

  Utökad sökning

onr:"swepub:oai:lup.lub.lu.se:409f6fd3-78a9-4f32-bda7-25e874610a50"
 

Sökning: onr:"swepub:oai:lup.lub.lu.se:409f6fd3-78a9-4f32-bda7-25e874610a50" > Effects of antenata...

  • Rogozińska, EwelinaQueen Mary University (författare)

Effects of antenatal diet and physical activity on maternal and fetal outcomes : Individual patient data meta-analysis and health economic evaluation

  • Artikel/kapitelEngelska2017

Förlag, utgivningsår, omfång ...

  • 2017-08
  • National Institute for Health Research,2017

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:409f6fd3-78a9-4f32-bda7-25e874610a50
  • https://lup.lub.lu.se/record/409f6fd3-78a9-4f32-bda7-25e874610a50URI
  • https://doi.org/10.3310/hta21410DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • Background: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes. Objectives: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions. Data sources: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Technology Assessment database were searched from October 2013 to March 2015 (to update a previous search). Review methods: Researchers from the International Weight Management in Pregnancy Collaborative Network shared the primary data. For each intervention type and outcome, we performed a two-step IPD random-effects meta-analysis, for all women (except underweight) combined and for each subgroup of interest, to obtain summary estimates of effects and 95% confidence intervals (CIs), and synthesised the differences in effects between subgroups. In the first stage, we fitted a linear regression adjusted for baseline (for continuous outcomes) or a logistic regression model (for binary outcomes) in each study separately; estimates were combined across studies using random-effects meta-analysis models. We quantified the relationship between weight gain and complications, and undertook a decision-analytic model-based economic evaluation to assess the cost-effectiveness of the interventions. Results: Diet and lifestyle interventions reduced GWG by an average of 0.70 kg (95% CI-0.92 to-0.48 kg; 33 studies, 9320 women). The effects on composite maternal outcome [summary odds ratio (OR) 0.90, 95% CI 0.79 to 1.03; 24 studies, 8852 women] and composite fetal/neonatal outcome (summary OR 0.94, 95% CI 0.83 to 1.08; 18 studies, 7981 women) were not significant. The effect did not vary with baseline BMI, age, ethnicity, parity or underlying medical conditions for GWG, and composite maternal and fetal outcomes. Lifestyle interventions reduce Caesarean sections (OR 0.91, 95% CI 0.83 to 0.99), but not other individual maternal outcomes such as gestational diabetes mellitus (OR 0.89, 95% CI 0.72 to 1.10), pre-eclampsia or pregnancy-induced hypertension (OR 0.95, 95% CI 0.78 to 1.16) and preterm birth (OR 0.94, 95% CI 0.78 to 1.13). There was no significant effect on fetal outcomes. The interventions were not cost-effective. GWG, including adherence to the Institute of Medicine-recommended targets, was not associated with a reduction in complications. Predictors of GWG were maternal age (summary estimate-0.10 kg, 95% CI-0.14 to-0.06 kg) and multiparity (summary estimate-0.73 kg, 95% CI-1.24 to-0.23 kg). Limitations: The findings were limited by the lack of standardisation in the components of intervention, residual heterogeneity in effects across studies for most analyses and the unavailability of IPD in some studies. Conclusion: Diet and lifestyle interventions in pregnancy are clinically effective in reducing GWG irrespective of risk factors, with no effects on composite maternal and fetal outcomes. Future work: The differential effects of lifestyle interventions on individual pregnancy outcomes need evaluation. Study registration: This study is registered as PROSPERO CRD42013003804.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Marlin, NadineQueen Mary University (författare)
  • Jackson, Louise E.University of Birmingham (författare)
  • Rayanagoudar, GirishQueen Mary University (författare)
  • Ruifrok, Anneloes EAmsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC) (författare)
  • Dodds, JulieQueen Mary University (författare)
  • Molyneaux, EmmaKing's College London (författare)
  • van Poppel, Mireille N MAmsterdam UMC - Vrije Universiteit Amsterdam,Karl-Franzens-University of Graz (författare)
  • Poston, LucillaKing's College London (författare)
  • Vinter, Christina A.Odense University Hospital (författare)
  • McAuliffe, FionnualaUniversity College Dublin (författare)
  • Dodd, Jodie M.University of Adelaide (författare)
  • Owens, JulieUniversity of Adelaide (författare)
  • Barakat Carballo, RubenTechnical University of Madrid (författare)
  • Perales, MariaTechnical University of Madrid (författare)
  • Cecatti, Jose GUniversity of Campinas (författare)
  • Surita, FernandaUniversity of Campinas (författare)
  • Yeo, Seon AeUniversity of North Carolina (författare)
  • Bogaerts, AnnickUniversity of Antwerp,University College Leuven-Limburg (författare)
  • Devlieger, RolandUniversity Hospitals Leuven (författare)
  • Teede, HelenaMonash University (författare)
  • Harrison, CheryceMonash University (författare)
  • Haakstad, LeneNorwegian School of Sport Sciences (författare)
  • Shen, Garry XUniversity of Manitoba (författare)
  • Shub, AlexisUniversity of Melbourne (författare)
  • El Beltagy, NermeenAlexandria University (författare)
  • Motahari, NargesMazandaran University (författare)
  • Khoury, JanetteOslo university hospital (författare)
  • Tonstad, SerenaOslo university hospital (författare)
  • Luoto, RiittaUKK Institute for Health Promotion Research (författare)
  • Kinnunen, Tarja IUniversity of Tampere (författare)
  • Guelfi, KymUniversity of Western Australia, Crawley (författare)
  • Facchinetti, FabioUniversity of Modena and Reggio Emilia (författare)
  • Petrella, ElisabettaUniversity of Modena and Reggio Emilia (författare)
  • Phelan, SuzanneCalifornia Polytechnic State University (författare)
  • Scudeller, Tânia TEscola Paulista de Medicina (författare)
  • Rauh, KathrinTechnical University of Munich,Competence Centre for Nutrition (KErn) (författare)
  • Hauner, HansTechnical University of Munich (författare)
  • Renault, KristinaOdense University Hospital,University of Copenhagen (författare)
  • de Groot, Christianne J MAmsterdam UMC - Vrije Universiteit Amsterdam (författare)
  • Sagedal, Linda RemeSørlandet Hospital (författare)
  • Vistad, IngvildSørlandet Hospital (författare)
  • Stafne, Signe NilssenNorwegian University of Science and Technology,St. Olav’s University Hospital (författare)
  • Mørkved, SivSt. Olav’s University Hospital,Norwegian University of Science and Technology (författare)
  • Salvesen, Kjell Å.Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Norwegian University of Science and Technology(Swepub:lu)med-ks4 (författare)
  • Jensen, Dorte M.Odense University Hospital (författare)
  • Vitolo, MárciaFederal University of Health Sciences of Porto Alegre (författare)
  • Astrup, ArneUniversity of Copenhagen (författare)
  • Geiker, Nina Rica WiumCopenhagen University Hospital (författare)
  • Kerry, SallyQueen Mary University (författare)
  • Queen Mary UniversityUniversity of Birmingham (creator_code:org_t)
  • International Weight Management in Pregnancy (i-WIP) Collaborative Group

Sammanhörande titlar

  • Ingår i:Health Technology Assessment: National Institute for Health Research21:411366-52782046-4924

Internetlänk

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy