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Effects of antenata...
Effects of antenatal diet and physical activity on maternal and fetal outcomes : Individual patient data meta-analysis and health economic evaluation
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- Rogozińska, Ewelina (författare)
- Queen Mary University
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- Marlin, Nadine (författare)
- Queen Mary University
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- Jackson, Louise E. (författare)
- University of Birmingham
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- Rayanagoudar, Girish (författare)
- Queen Mary University
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- Ruifrok, Anneloes E (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- Dodds, Julie (författare)
- Queen Mary University
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- Molyneaux, Emma (författare)
- King's College London
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- van Poppel, Mireille N M (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Karl-Franzens-University of Graz
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- Poston, Lucilla (författare)
- King's College London
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- Vinter, Christina A. (författare)
- Odense University Hospital
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- McAuliffe, Fionnuala (författare)
- University College Dublin
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- Dodd, Jodie M. (författare)
- University of Adelaide
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- Owens, Julie (författare)
- University of Adelaide
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- Barakat Carballo, Ruben (författare)
- Technical University of Madrid
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- Perales, Maria (författare)
- Technical University of Madrid
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- Cecatti, Jose G (författare)
- University of Campinas
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- Surita, Fernanda (författare)
- University of Campinas
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- Yeo, Seon Ae (författare)
- University of North Carolina
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- Bogaerts, Annick (författare)
- University of Antwerp,University College Leuven-Limburg
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- Devlieger, Roland (författare)
- University Hospitals Leuven
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- Teede, Helena (författare)
- Monash University
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- Harrison, Cheryce (författare)
- Monash University
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- Haakstad, Lene (författare)
- Norwegian School of Sport Sciences
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- Shen, Garry X (författare)
- University of Manitoba
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- Shub, Alexis (författare)
- University of Melbourne
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- El Beltagy, Nermeen (författare)
- Alexandria University
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- Motahari, Narges (författare)
- Mazandaran University
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- Khoury, Janette (författare)
- Oslo university hospital
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- Tonstad, Serena (författare)
- Oslo university hospital
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- Luoto, Riitta (författare)
- UKK Institute for Health Promotion Research
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- Kinnunen, Tarja I (författare)
- University of Tampere
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- Guelfi, Kym (författare)
- University of Western Australia, Crawley
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- Facchinetti, Fabio (författare)
- University of Modena and Reggio Emilia
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- Petrella, Elisabetta (författare)
- University of Modena and Reggio Emilia
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- Phelan, Suzanne (författare)
- California Polytechnic State University
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- Scudeller, Tânia T (författare)
- Escola Paulista de Medicina
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- Rauh, Kathrin (författare)
- Technical University of Munich,Competence Centre for Nutrition (KErn)
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- Hauner, Hans (författare)
- Technical University of Munich
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- Renault, Kristina (författare)
- Odense University Hospital,University of Copenhagen
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- de Groot, Christianne J M (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Sagedal, Linda Reme (författare)
- Sørlandet Hospital
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- Vistad, Ingvild (författare)
- Sørlandet Hospital
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- Stafne, Signe Nilssen (författare)
- Norwegian University of Science and Technology,St. Olav’s University Hospital
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- Mørkved, Siv (författare)
- St. Olav’s University Hospital,Norwegian University of Science and Technology
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- Salvesen, Kjell Å. (författare)
- 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
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- Jensen, Dorte M. (författare)
- Odense University Hospital
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- Vitolo, Márcia (författare)
- Federal University of Health Sciences of Porto Alegre
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- Astrup, Arne (författare)
- University of Copenhagen
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- Geiker, Nina Rica Wium (författare)
- Copenhagen University Hospital
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- Kerry, Sally (författare)
- Queen Mary University
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(creator_code:org_t)
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- 2017-08
- 2017
- Engelska.
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Ingår i: Health Technology Assessment. - : National Institute for Health Research. - 1366-5278 .- 2046-4924. ; 21:41
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://njl-admin.ni...
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https://lup.lub.lu.s...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- 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
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
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Rogozińska, Ewel ...
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Marlin, Nadine
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Jackson, Louise ...
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Rayanagoudar, Gi ...
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Ruifrok, Anneloe ...
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Dodds, Julie
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visa fler...
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Molyneaux, Emma
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van Poppel, Mire ...
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Poston, Lucilla
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Vinter, Christin ...
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McAuliffe, Fionn ...
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Dodd, Jodie M.
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Owens, Julie
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Barakat Carballo ...
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Perales, Maria
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Cecatti, Jose G
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Surita, Fernanda
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Yeo, Seon Ae
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Bogaerts, Annick
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Devlieger, Rolan ...
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Teede, Helena
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Harrison, Cheryc ...
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Haakstad, Lene
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Shen, Garry X
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Shub, Alexis
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El Beltagy, Nerm ...
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Motahari, Narges
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Khoury, Janette
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Tonstad, Serena
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Luoto, Riitta
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Kinnunen, Tarja ...
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Guelfi, Kym
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Facchinetti, Fab ...
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Petrella, Elisab ...
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Phelan, Suzanne
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Scudeller, Tânia ...
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Rauh, Kathrin
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Hauner, Hans
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Renault, Kristin ...
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de Groot, Christ ...
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Sagedal, Linda R ...
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Vistad, Ingvild
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Stafne, Signe Ni ...
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Mørkved, Siv
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Salvesen, Kjell ...
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Jensen, Dorte M.
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Vitolo, Márcia
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Astrup, Arne
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Geiker, Nina Ric ...
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Kerry, Sally
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och Reproduktionsmed ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Näringslära
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