產前生活型態介入可以改善懷孕結果


  【24drs.com】紐奧良舉辦的美國糖尿病協會第76屆科學研討會中,有報告指出,懷孕期間採用改善飲食與運動的介入方式,可降低母親的妊娠糖尿病風險和改善嬰兒的結果。
  
  會議主持人、克里夫蘭凱斯西儲大學MetroHealth生殖健康中心主任Patrick Catalano醫師表示,如果是懷孕體重增加情況時,就要個別制定方法;他在會後表示,有很多的變化,個人的生理和代謝因素、以及社會、民族和文化差異,都會影響懷孕時的體重。
  
  健康飲食和運動的一次性處方,或許無法幫助大部份婦女;他解釋,這需要在懷孕期間持續討論與調整,也就是介入方式須一路調整。
  
  熱量計算與能量消耗也要考量,Catalano醫師指出,不過,懷孕期間可能會出現我們尚未全盤瞭解的代謝變化,可能會使介入方式複雜化。
  
  Catalano醫師表示,醫學研究院發行的懷孕期間體重增加建議是相當好的起點。
  
  不過,他指出,醫師不一定是幫助這些婦女的最佳專業人士,營養學家、行為學家和運動治療師通常會有更好的立場提供適當的建議與諮商。
  
  Catalano醫師表示,我的開業處有一名營養師,我希望我能聘一位行為學家。當然,會有經濟上的影響,即使是健康的飲食也可能是昂貴的,因此許多人無法接受。
  
  發表研究者、國家糖尿病、消化道暨腎臟疾病研究所的William Knowler醫師表示,對母嬰有利的營養或運動諮商,許多健康體系並未給付。
  
  Knowler 醫師表示,會議後有許多提問,我後來聽說的非正式觀點是:不幸的是,我們目前的介入並不是更有益的,在這個重要領域一直沒有更多進展。
  
  資料來源: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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