Prevention of Gestational Diabetes Design of a Cluster-Randomized Controlled Trial and One-Year Follow-Up 英文参考文献.docVIP

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Prevention of Gestational Diabetes Design of a Cluster-Randomized Controlled Trial and One-Year Follow-Up 英文参考文献.doc

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Prevention of Gestational Diabetes Design of a Cluster-Randomized Controlled Trial and One-Year Follow-Up 英文参考文献

Luotoetal.BMCPregnancyandChildbirth2010,10:39 /1471-2393/10/39 STUDY PROTOCOL OpenAccess PreventionofGestationalDiabetes:Designof aCluster-RandomizedControlledTrialand One-YearFollow-Up RiittaMLuoto1,2*,TarjaIKinnunen3,MinnaAittasalo1,KatriinaOjala1,KirsiMansikkam?ki1,ErjaToropainen1, P?iviKolu1,TommiVasankari1,2 Abstract Background:Annualprevalenceofgestationaldiabetesmellitus(GDM)is12.5%amongFinnishpregnantwomen. Theprevalenceisexpectedtorisewiththeincreasingoverweightamongwomenbeforepregnancy.Physical activityanddietarebothknowntohavefavourableeffectsoninsulinresistanceandpossiblyontheriskofGDM. Weaimedtoinvestigate,whetherGDMcanbepreventedbycounselingondiet,physicalactivityandgestational weightgainduringpregnancy. Methods/Design:Acluster-randomizedcontrolledtrialwasconductedin14municipalitiesinthesouthernpartof Finland.Pairwiserandomizationwasperformedinordertotakeintoaccountsocioeconomicdifferences.Recruited womenwereat8-12weeksgestationandfulfilledatleastoneofthefollowingcriteria:bodymassindex≥25kg/ m2,historyofearliergestationalglucoseintoleranceormacrosomicnewborn(4500g),age≥40years,firstor seconddegreerelativewithhistoryoftype1or2diabetes.Mainexclusioncriterionwaspathologicaloralglucose tolerancetest(OGTT)at8-12weeksgestation.Thetrialincludedonecounselingsessiononphysicalactivityat8- 12weeksgestationandonefordietat16-18weeksgestation,andthreetofourboostersessionsduringother routinevisits.Inthecontrolclinicswomenreceivedusualcare.Informationonheight,weightgainandother gestationalfactorswasobtainedfrommaternitycards.Physicalactivity,dietaryintakeandqualityoflifewere followedbyquestionnairesduringpregnancyandat1-yearpostpartum.Bloodsamplesforlipidstatus,hormones, insulinandOGTTweretakenat8-12and26-28weeksgestationand1yearpostpartum.Workabilityandreturnto workwereelicitedbyaquestionnaireat1-yearpostpartum.Linkagetothenationalbirthregisterofyears2007- 2009willprovideinformationonperinatalcomplicationsandGDMincidenceamongthenon-participantsofthe study.Cost-effe