北京大学学报（医学版）2025，Vol.57Issue(3)：465-472,8.DOI:10.19723/j.issn.1671-167X.2025.03.009
基于移动健康技术对超重或肥胖孕妇体重管理的随机对照试验
A randomized controlled trial of weight management based on mobile health techno-logy among overweight or obese pregnant women
摘要
Abstract
Objective:To evaluate the effect of lifestyle interventions based on mobile health technolo-gy on gestational weight gain among overweight or obese pregnant women,to explore the influencing fac-tors of the intervention effect,and to provide scientific evidence for weight management during pregnan-cy.Methods:The randomized controlled trial(RCT)design was used.From April 2024 to August 2024,200 singleton overweight or obese pregnant women aged 18-40 years in early pregnancy were re-cruited and stratified block-randomized according to body mass index(BMI)categories,age,and parity.The control group received routine prenatal care,while the intervention group received lifestyle interven-tions based on mobile health technology,which included biweekly face-to-face or telephone sessions;weekly recording of dietary behavior goals with personalized feedback on WeChat public account;6 000 steps per day and 150 minutes of brisk walking per week;and weekly weight recording with personalized feedback.Based on the intention-to-treat principle,generalized linear mixed models were used to analyze the effects on weight gain and weight gain rate up to 24-28 gestational weeks,gestational diabetes melli-tus(GDM),and dietary and physical activity behaviors.Additionally,subgroup analysis and interaction analysis were conducted to explore whether intervention effects on weight gain varied by different maternal characteristics.Results:The mean age of the women in the intervention and control groups was(30.49±3.99)years and(29.83±3.95)years,respectively,with gestational weeks at enrollment being(11.35±1.61)weeks and(11.26±1.52)weeks.No statistically significant differences were observed in the baseline characteristics between the two groups(P＞0.05).In the study,10 and 12 participants were lost to the follow-up in the intervention and control groups,respectively,with 178 women comple-ting the midterm follow-up.At the midterm follow-up(24-28 weeks),the weight gain in the interven-tion and control groups was(5.00±3.72)kg and(6.57±4.28)kg,respectively.After adjusting for age,parity,gravidity,region,pre-pregnancy BMI categories,and socioeconomic status,the between-group difference was-1.63 kg(95％CI:-2.80 to-0.46;P=0.007).The adjusted between-group difference in weight gain rate was-0.07 kg/week(95％CI:-0.11 to-0.02;P=0.005).Com-pared with the control group,the intervention group had lower fasting blood glucose at the oral glucose tolerance test(OGTT)by 0.19 mmol/L(95％CI:0.04 to0.33;P=0.013).No significant difference was observed in GDM incidence between the two groups.Among different subgroups based on characteris-tics,such as age,region,socioeconomic status,and parity,there was no statistically significant dif-ference in the effect on weight gain.Conclusion:The lifestyle interventions based on mobile health tech-nology effectively controlled weight gain up to 24-28 gestational weeks among overweight or obese women and improved fasting blood glucose level.This has significant public health implications for impro-ving the health of overweight or obese pregnant women in China.关键词
孕期体重增长/超重/肥胖/随机对照试验/移动健康Key words
Gestational weight gain/Overweight/Obesity/Randomized controlled trial/Mobile health分类
临床医学引用本文复制引用
李萍,王海雪,高晓,韩亚静,王辉,王海俊,牟莹莹..基于移动健康技术对超重或肥胖孕妇体重管理的随机对照试验[J].北京大学学报（医学版）,2025,57(3):465-472,8.基金项目
北京大学医学部-潍坊市妇幼健康联合研究中心(PKUWF-Y09)Supported by Peking University Health Science Center-Weifang Ma-ternal and Child Health Joint Research Center(PKUWF-Y09) （PKUWF-Y09）
