产前生活型态介入可以改善怀孕结果


  【24drs.com】纽奥良举办的美国糖尿病协会第76届科学研讨会中,有报告指出,怀孕期间采用改善饮食与运动的介入方式,可降低母亲的妊娠糖尿病风险和改善婴儿的结果。
  
  会议主持人、克里夫兰凯斯西储大学MetroHealth生殖健康中心主任Patrick Catalano医师表示,如果是怀孕体重增加情况时,就要个别制定方法;他在会后表示,有很多的变化,个人的生理和代谢因素、以及社会、民族和文化差异,都会影响怀孕时的体重。
  
  健康饮食和运动的一次性处方,或许无法帮助大部份妇女;他解释,这需要在怀孕期间持续讨论与调整,也就是介入方式须一路调整。
  
  热量计算与能量消耗也要考量,Catalano医师指出,不过,怀孕期间可能会出现我们尚未全盘了解的代谢变化,可能会使介入方式复杂化。
  
  Catalano医师表示,医学研究院发行的怀孕期间体重增加建议是相当好的起点。
  
  不过,他指出,医师不一定是帮助这些妇女的最佳专业人士,营养学家、行为学家和运动治疗师通常会有更好的立场提供适当的建议与谘商。
  
  Catalano医师表示,我的开业处有一名营养师,我希望我能聘一位行为学家。当然,会有经济上的影响,即使是健康的饮食也可能是昂贵的,因此许多人无法接受。
  
  发表研究者、国家糖尿病、消化道暨肾脏疾病研究所的William Knowler医师表示,对母婴有利的营养或运动谘商,许多健康体系并未给付。
  
  Knowler 医师表示,会议后有许多提问,我后来听说的非正式观点是:不幸的是,我们目前的介入并不是更有益的,在这个重要领域一直没有更多进展。
  
  资料来源:http://www.24drs.com/
  
  Native link:Antenatal Lifestyle Interventions Improve Pregnancy Outcomes

Antenatal Lifestyle Interventions Improve Pregnancy Outcomes

By Allison Shelley
Medscape Medical News

During pregnancy, early interventions to improve diet and exercise lower the risk for gestational diabetes and ameliorate outcomes for women and their babies, meeting attendees heard during a well-attended session at the American Diabetes Association 76th Scientific Sessions in New Orleans.

But one size does not fit all when it comes to pregnancy weight gain, said session chair Patrick Catalano, MD, director of the Center for Reproductive Health at MetroHealth and Case Western Reserve University in Cleveland.

"There is a lot of variation," he told Medscape Medical News after the session. "There are individual physiologic and metabolic factors and societal, ethnic, and cultural differences that can all influence weight during pregnancy."

A one-time prescription for healthy eating and exercise probably won't help most women. "It needs to be an ongoing conversation that evolves over the course of the pregnancy," he explained. And interventions need to be adjusted along the way.

Calorie counts and energy expenditure are part of the issue, "but metabolic changes also take place during pregnancy that we don't know all that much about yet, and that may complicate interventions," Dr Catalano pointed out.

Recommendations on weight gain during pregnancy, issued by the Institute of Medicine, are an excellent starting point, Dr Catalano said.

There are individual physiologic and metabolic factors and societal, ethnic, and cultural differences that can all influence weight during pregnancy.

But, he added, physicians are not always the best professionals to help these women. Nutritionists, behaviorists, and exercise therapists are often in a better position to provide appropriate advice and counseling.

"My practice has a nutritionist and I wish we had a behaviorist," said Dr Catalano. "There are economic implications and, of course, even healthy eating can be expensive and therefore inaccessible to many."

Several health systems do not pay for the nutritional or exercise counseling that would benefit mothers and babies, said presenter William Knowler, MD, from the National Institute of Diabetes and Digestive and Kidney Diseases.

"There were a lot of questions after the session," Dr Knowler told Medscape Medical News. "The informal sentiment I heard afterward is that it's unfortunate that our current interventions aren't more beneficial and there hasn't been more progress in this important area."

Dr Catalano and Dr Knowler have disclosed no relevant financial relationships.

American Diabetes Association (ADA) 76th Scientific Sessions: Session3-CT-SY04. Presented June11, 2016.

    
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