MON-LB8 A Preconception Lifestyle Intervention Maintained Throughout Pregnancy Improves Some Gestational and Neonatal Outcomes in Women With Obesity and Infertility
Notice bibliographique
Résumé
Abstract Background : Obesity in women of childbearing age is associated with infertility and increases significantly the risks of many pregnancy and neonatal complications. Adopting a healthy lifestyle prior conception and maintaining it during pregnancy may reduce these complications. Our aim was therefore to determine whether a lifestyle program targeting women with obesity and infertility and maintained during pregnancy improves gestational and neonatal outcomes. Methods : We report on 46 women who became pregnant and had available outcome data during pregnancy and at birth, among 127 women with infertility and obesity (body mass index, BMI ≥30 kg/m²), or overweight with PCOS (BMI ≥27 kg/m²), who were enrolled in a lifestyle randomized-controlled trial. Participants were randomized to the control group (CG, n=20), who received standard of care, or the lifestyle group (LSG, n=26), who followed a lifestyle program alone for 6 months, and then in combination with usual fertility care for 18 months or until the end of pregnancy. Pregnancy and neonatal outcomes were retrospectively retrieved from mothers’ and newborns’ medical records. Results : At enrollment, both groups were similar for age (29.3 vs 31.0 years), BMI (38.7 vs 38.4 kg/m2) and waist circumference (113.7 vs 112.7 cm). Preconception weight loss was significantly higher in the LSG compared to the CG (4.86 kg vs 1.21 kg, p=0.013), but gestational weight gains were similar (+10.83 vs +10.52 kg, p=0.987). During pregnancy, groups did not differ for the rates of preeclampsia, gestational diabetes or other clinical outcomes, but significantly less women in the LSG required insulin for treatment of their gestational diabetes (12.5% vs 42.1%, p=0.027) as well as urgent cesarean section due to failure of vaginal delivery (0.0% vs 21.1%, p=0.021). Regarding neonatal outcomes, there was no significant difference between groups for gestational age, weight at birth and head circumference, as well as rates of prematurity, LGA, SGA, birth defects or other clinical outcomes, but babies from the LSG displayed significantly lower tricipital skinfolds (4.73 mm vs 5.72 mm, p=0.031) and trends for lower sum of four skinfolds (16.61 mm vs 19.06 mm, p=0.056) and increased length at birth (50.82 cm vs 49.63 cm, p=0,053). Conclusion : In women with obesity and infertility, our lifestyle program initiated prior to fertility treatments and maintained throughout pregnancy improved their preconception weight and lifestyle, but not their gestational weight gain. Such intervention was nonetheless effective to reduce significantly some clinically relevant pregnancy and neonatal complications. If these results are replicated in a larger sample, it would strongly suggest that women with obesity should be supported to adopt a healthy lifestyle prior conception in order to increase their likelihood of giving birth to a healthy baby.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».