产后生活方式干预对体重下降、戒烟和预防复吸的影响：系统综述
2011/03/23
摘要
对于妊娠期出现先兆子痫、宫内生长迟缓和/或妊娠糖尿病的女性，产后推荐采用生活方式干预，因为这些女性患者患有心血管疾病的风险呈现增加趋势。为寻找降低该风险的潜在干预措施，本文对前期针对体重下降、戒烟和预防复吸的产后生活方式干预的相关研究进行系统综述，并对这些产后生活方式干预措施的效果进行总结。检索的数据库有PubMed、Embase、科学网、PsychInfo和Cinahl 数据库，检索对象为针对体重下降、戒烟或预防复吸的产后生活方式干预研究，这些干预措施需在产后1年内进行。对于存在上述妊娠并发症的女性，尚未有试验对产后生活方式干预的有效性进行研究。然而，本综述入选21项有关产后生活方式干预的研究，研究对象为未经筛选的产后女性（无妊娠并发症）。8个针对体重下降的干预措施中的6项措施、5个针对戒烟的干预措施中的4项措施及8项针对预防复发的干预措施中的4项措施，均显示有效。个性化咨询、团体咨询、记日记或其他相关资料为有效的措施。目前，尚未有针对存在妊娠并发症的女性的产后生活方式干预措施。随着发展，有理由相信，在未经筛选女性中使用的产后生活方式干预措施，对于存在妊娠并发症的女性也可能有效。
学习目标：完成此项教育性活动后，产科/妇科医生更应该：询问患者怎样使用已有的、针对体重下降、戒烟和预防复吸的产后生活方式干预措施，来降低未来心血管疾病风险；对出现过妊娠先兆子痫、宫内生长迟缓和/或妊娠糖尿病的产后女性，进行宣教，告知其未来心血管病风险有增加的趋势。
目标人群：产科医生、妇科医生、家庭医生。
（林江涛 审校）
Obstet Gynecol Surv. 2010 Oct;65(10):631-652.
Effect of Postpartum Lifestyle Interventions on Weight Loss, Smoking Cessation, and Prevention of Smoking Relapse: A Systematic Review.
Hoedjes M, Berks D, Vogel I, Franx A, Visser W, Duvekot JJ, Habbema JD, Steegers EA, Raat H.
Abstract
Postpartum lifestyle interventions are recommended for women after pregnancies complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes, since they are at increased cardiovascular risk. To identify potential intervention strategies to reduce this risk, a systematic review of the literature is presented on the effectiveness of postpartum lifestyle interventions aimed at weight loss, smoking cessation, and smoking relapse prevention. The main characteristics of these postpartum lifestyle interventions are briefly described. The PubMed, Embase, Web of Science, PsychInfo, and Cinahl databases were searched for studies on the effects of postpartum lifestyle interventions on weight loss, and smoking cessation or prevention of smoking relapse, initiated for up to 1 year postpartum. No studies on the effectiveness of postpartum lifestyle interventions after the aforementioned specific pregnancy complications were found. However, 21 studies are included that describe existing postpartum lifestyle interventions, which were applied to unselected (on the basis of pregnancy complications) postpartum women. Six of 8 weight loss interventions, 4 of 5 smoking cessation interventions, and 4 of 8 smoking relapse prevention interventions were effective. Individually tailored counseling, group counseling sessions, and use of diaries or other correspondence materials were shown to be effective. Currently, postpartum lifestyle interventions tailored specifically for women who experienced the pregnancy complications are lacking. While awaiting their development, it seems reasonable to utilize existing lifestyle interventions shown to be effective in unselected postpartum women.
Learning Objectives: After completion of this educational activity, the obstetrician/gynecologist should be better able to: counsel patients on how to apply existing postpartum lifestyle intervention strategies aimed at weight loss, smoking cessation, and smoking relapse prevention to lower future cardiovascular risk; and educate postpartum women who have experienced preeclampsia, intra-uterine growth restriction, and/or gestational diabetes about their increased cardiovascular risk later in life.
Target Audience: Obstetricians & Gynecologists, Family Physicians.
Obstet Gynecol Surv. 2010 Oct;65(10):631-652.
对于妊娠期出现先兆子痫、宫内生长迟缓和/或妊娠糖尿病的女性，产后推荐采用生活方式干预，因为这些女性患者患有心血管疾病的风险呈现增加趋势。为寻找降低该风险的潜在干预措施，本文对前期针对体重下降、戒烟和预防复吸的产后生活方式干预的相关研究进行系统综述，并对这些产后生活方式干预措施的效果进行总结。检索的数据库有PubMed、Embase、科学网、PsychInfo和Cinahl 数据库，检索对象为针对体重下降、戒烟或预防复吸的产后生活方式干预研究，这些干预措施需在产后1年内进行。对于存在上述妊娠并发症的女性，尚未有试验对产后生活方式干预的有效性进行研究。然而，本综述入选21项有关产后生活方式干预的研究，研究对象为未经筛选的产后女性（无妊娠并发症）。8个针对体重下降的干预措施中的6项措施、5个针对戒烟的干预措施中的4项措施及8项针对预防复发的干预措施中的4项措施，均显示有效。个性化咨询、团体咨询、记日记或其他相关资料为有效的措施。目前，尚未有针对存在妊娠并发症的女性的产后生活方式干预措施。随着发展，有理由相信，在未经筛选女性中使用的产后生活方式干预措施，对于存在妊娠并发症的女性也可能有效。
学习目标：完成此项教育性活动后，产科/妇科医生更应该：询问患者怎样使用已有的、针对体重下降、戒烟和预防复吸的产后生活方式干预措施，来降低未来心血管疾病风险；对出现过妊娠先兆子痫、宫内生长迟缓和/或妊娠糖尿病的产后女性，进行宣教，告知其未来心血管病风险有增加的趋势。
目标人群：产科医生、妇科医生、家庭医生。
（林江涛 审校）
Obstet Gynecol Surv. 2010 Oct;65(10):631-652.
Effect of Postpartum Lifestyle Interventions on Weight Loss, Smoking Cessation, and Prevention of Smoking Relapse: A Systematic Review.
Hoedjes M, Berks D, Vogel I, Franx A, Visser W, Duvekot JJ, Habbema JD, Steegers EA, Raat H.
Abstract
Postpartum lifestyle interventions are recommended for women after pregnancies complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes, since they are at increased cardiovascular risk. To identify potential intervention strategies to reduce this risk, a systematic review of the literature is presented on the effectiveness of postpartum lifestyle interventions aimed at weight loss, smoking cessation, and smoking relapse prevention. The main characteristics of these postpartum lifestyle interventions are briefly described. The PubMed, Embase, Web of Science, PsychInfo, and Cinahl databases were searched for studies on the effects of postpartum lifestyle interventions on weight loss, and smoking cessation or prevention of smoking relapse, initiated for up to 1 year postpartum. No studies on the effectiveness of postpartum lifestyle interventions after the aforementioned specific pregnancy complications were found. However, 21 studies are included that describe existing postpartum lifestyle interventions, which were applied to unselected (on the basis of pregnancy complications) postpartum women. Six of 8 weight loss interventions, 4 of 5 smoking cessation interventions, and 4 of 8 smoking relapse prevention interventions were effective. Individually tailored counseling, group counseling sessions, and use of diaries or other correspondence materials were shown to be effective. Currently, postpartum lifestyle interventions tailored specifically for women who experienced the pregnancy complications are lacking. While awaiting their development, it seems reasonable to utilize existing lifestyle interventions shown to be effective in unselected postpartum women.
Learning Objectives: After completion of this educational activity, the obstetrician/gynecologist should be better able to: counsel patients on how to apply existing postpartum lifestyle intervention strategies aimed at weight loss, smoking cessation, and smoking relapse prevention to lower future cardiovascular risk; and educate postpartum women who have experienced preeclampsia, intra-uterine growth restriction, and/or gestational diabetes about their increased cardiovascular risk later in life.
Target Audience: Obstetricians & Gynecologists, Family Physicians.
Obstet Gynecol Surv. 2010 Oct;65(10):631-652.
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