پایگاه علمی سعید سان دانلود رایگان مقالات علمی کنفرانس و ژورنال
پیش زمینه: افزایش شیوع چاقی در زنان باردار در استرالیا و دیگر کشورهای توسعه یافته یک نگرانی مشخص و معنی دار در زمینه سلامت عمومی می باشد. چاقی زنان به عنوان یک خطر در حال افزایش می باشد که به صورت جدی مورد بررسی قرار گرفته است و در زمینه جلوگیری از افزایش وزن و دیگر مراقبت ها پیشنهاداتی شده است. شواهد محدودی برای حمایت کردن از رژیم غذایی مناسب و سبک زندگی فعال به منظور کاهش وزن وجود دارد و ارزیابی های کمی در این زمینه صورت گرفته است. هدف اولیه این پروژه ارزیابی تاثیر پیوستگی و مداومت مراقبت مامایی و بارداری برای جلوگیری کردن از افزایش وزن در زنان چاق می باشد. اهداف ثانویه این مطالعه ارزیابی تاثیر مداوم بودن مراقبت های بارداری بر: تجربه زنان از مراقبت های بارداری، رضایت زنان از این مراقبت ها و یک سری از فاکتورهای فیزیولوژیکی است.
Continuity of midwifery care and gestational
weight gain in obese women: a randomised
controlled trial
Cate Nagle1*†, Helen Skouteris2†, Anne Hotchin3, Lauren Bruce2, Denise Patterson4 and Glyn Teale5
Abstract
Background: The increased prevalence of obesity in pregnant women in Australia and other developed countries
is a significant public health concern. Obese women are at increased risk of serious perinatal complications and
guidelines recommend weight gain restriction and additional care. There is limited evidence to support the
effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and
new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of
midwifery care on restricting gestational weight gain in obese women to the recommended range. The secondary
aims of the study are to assess the impact of continuity of midwifery care on: women’s experience of pregnancy
care; women’s satisfaction with care and a range of psychological factors.
Methods/Design: A two arm randomised controlled trial (RCT) will be conducted with primigravid women
recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI≥30 who
are less than 17 weeks gestation. Women allocated to the intervention arm will be cared for in a midwifery
continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women
allocated to the control group will receive routine care in addition to the same informational leaflet. Weight gain
during pregnancy, standards of care, medical and obstetric information will be extracted from medical records.
Data collected at recruitment (self administered survey) and at 36 weeks by postal survey will include sociodemographic
information and the use of validated scales to measure secondary outcomes.
Discussion: Continuity of midwifery care models are well aligned with current Victorian, Australian and many
international government policies on maternity care. Increasingly, midwifery continuity models of care are being
introduced in low risk maternity care, and information on their application in high risk populations is required.
There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women
who are obese and the findings from this project may have application in other maternity services. In addition this
study will inform a larger trial that will focus on birth and postnatal outcomes.
Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12610001078044.
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