肥満と減量療法のジャーナル

抽象的な

Gestational Weight Gain and Changes in Body Composition in Pregnant Women with BMI 25 Kg/m2 Undergoing a Healthy Lifestyle Program Starting Early in Pregnancy

Marcella Malavolti*, Elisabetta Petrella, Valentina Bertarini, Dietitian, Cristina Cicchetti, Isabella Neri and Fabio Facchinetti

Introduction: we evaluated the utility of bioimpedance analysis and the SenseWear armband for monitoring gestational weight gain (GWG) in overweight/obese pregnant women. Materials and methods: Sixty overweight/obese pregnant women were recruited and advised to follow a physical activity (PA) program (sessions gradually increasing to 30 minutes of mild physical activity intensity per day at least 4-5 days a week) with caloric restriction (1500 kcal/day + 200 kcal/day for obese and 300 kcal/day for overweight women). Weight, GWG and body composition were measured at enrollment (within the 12th week of gestation), at the 16th, 20th, 32nd, and 36th week, at delivery and 12 weeks after delivery using BIA. The patients were also instructed to wear the SWA, for 5 consecutive days, at enrollment, and at the 20th and 36th weeks of gestation. Results: GWG at delivery was 12.6 ± 5.4 kg for overweight, 9.0 ± 8.0 kg for obese women and 3.3 ± 5.3 kg for morbidly obese women. Nine overweight (60.0%), 22 obese (66.7%) and 10 morbidly obese (90.9%) women remained within the Institute of Medicine recommended ranges at delivery. Overall percentual body composition changed significantly throughout pregnancy, (fat-free mass: 53.4 ± 6.1 to 56.9 ± 6.5; FM = 40.9 ± 12.8 to 44.1 ± 11.8, p < 0.05). Logistic regression analysis showed that women who adhered to the prescribed diet achieved a lower GWG (CI 95% = -1.65-0.54; r = -1.10, p = 0.001). Conclusion: The efficacy of the intervention depends directly on the adherence to the prescribed diet and PA program