Impacto do estilo de vida no controle do peso durante a gestação e pós-parto
Ano de defesa: | 2007 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , , |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade do Estado do Rio de Janeiro
|
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Saúde Coletiva
|
Departamento: |
Centro Biomédico::Instituto de Medicina Social
|
País: |
BR
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://www.bdtd.uerj.br/handle/1/4672 |
Resumo: | The aim of this thesis is to evaluate the impact of maternal life style on gestational weight gain (GWG) and maternal weight development during postpartum. Firstly, an overview of the literature on indicators used to measure weight changes during and after pregnancy was carried out (article I). Secondly, a multivariate logistic regression model was used to assess the association between prenatal smoking cessation and excessive GWG, according to the Institute of Medicine (IOM) recommendations, in 1.249 women who delivered a term infant in 1984/85 in Stockholm, Sweden (article II). Thirdly, a multivariate linear regression model was used to assess the effect of excessive GWG on maternal body mass index (BMI) at 15 years postpartum. The study population was composed of 483 Swedish women who were followed from delivery date of the index child in 1984/85 to 1999/2000 (article III). Finally, a systematic review with meta-analysis was conducted to appraise the effect of diet, exercise or both on postpartum weight loss (article IV). Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators used to calculate the GWG and postpartum weight retention. The reasons for non-significant associations between GWG and gestational outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute GWG (article I). Former smokers were 1,8 times more likely to gain excessive weight during pregnancy than nonsmokers, even after accounting for confounding factors, including alcohol consumption, physical activity to mention a few (article II). Postpartum weight retention at 15 years follow-up was higher among women who gained excessive weight during pregnancy (10,0 kg) than who gained weight according to IOM recommendations (6,7 kg). After accounting for confounding factors, women who gained excessive weight during pregnancy had a significant increase of 0.72 kg/m2 in BMI at 15 years follow-up compared to women who gained within recommendations (article III). Women who exercised did not significantly lose more weight than women in the control group (weighted mean difference (WMD) 0,00; 95% CI 8,63 to 8,63). Women who took part in a diet (WMD 1,70; 95% CI 2,08 to 1,32) or diet plus exercise (WMD 2,89; 95% CI 4,83 to 0,95) program lost significantly more weight than women in the control group. The interventions (diet; exercise; diet and exercise) did not adversely affect the maternal and child health (article IV). The findings indicate the relevance of early identification of women at risk of excessive GWG. Health care providers should give women appropriate advice for controlling GWG and motivate them to lose pregnancy-related weight during postpartum. Additionally, health care providers should recommend women to engage in diet combined with physical activity programs in order to lose postpartum weight and consequently prevent obesity associated with childbearing. |
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Lourenço, Paulo Mauricio Campanhahttp://lattes.cnpq.br/3452686086840985Coutinho, Evandro da Silva Freirehttp://lattes.cnpq.br/1020078557729775Sichieri, Roselyhttp://lattes.cnpq.br/4204048575326745Kac, Gilbertohttp://lattes.cnpq.br/3138999292930429Accioly, Elizabethhttp://lattes.cnpq.br/1962760740425690http://lattes.cnpq.br/4443418803788350Amorim, Amanda Rodrigues2020-08-02T16:53:05Z2014-05-062007-05-22AMORIM, Amanda Rodrigues. Impacto do estilo de vida no controle do peso durante a gestação e pós-parto. 2007. 161 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2007.http://www.bdtd.uerj.br/handle/1/4672The aim of this thesis is to evaluate the impact of maternal life style on gestational weight gain (GWG) and maternal weight development during postpartum. Firstly, an overview of the literature on indicators used to measure weight changes during and after pregnancy was carried out (article I). Secondly, a multivariate logistic regression model was used to assess the association between prenatal smoking cessation and excessive GWG, according to the Institute of Medicine (IOM) recommendations, in 1.249 women who delivered a term infant in 1984/85 in Stockholm, Sweden (article II). Thirdly, a multivariate linear regression model was used to assess the effect of excessive GWG on maternal body mass index (BMI) at 15 years postpartum. The study population was composed of 483 Swedish women who were followed from delivery date of the index child in 1984/85 to 1999/2000 (article III). Finally, a systematic review with meta-analysis was conducted to appraise the effect of diet, exercise or both on postpartum weight loss (article IV). Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators used to calculate the GWG and postpartum weight retention. The reasons for non-significant associations between GWG and gestational outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute GWG (article I). Former smokers were 1,8 times more likely to gain excessive weight during pregnancy than nonsmokers, even after accounting for confounding factors, including alcohol consumption, physical activity to mention a few (article II). Postpartum weight retention at 15 years follow-up was higher among women who gained excessive weight during pregnancy (10,0 kg) than who gained weight according to IOM recommendations (6,7 kg). After accounting for confounding factors, women who gained excessive weight during pregnancy had a significant increase of 0.72 kg/m2 in BMI at 15 years follow-up compared to women who gained within recommendations (article III). Women who exercised did not significantly lose more weight than women in the control group (weighted mean difference (WMD) 0,00; 95% CI 8,63 to 8,63). Women who took part in a diet (WMD 1,70; 95% CI 2,08 to 1,32) or diet plus exercise (WMD 2,89; 95% CI 4,83 to 0,95) program lost significantly more weight than women in the control group. The interventions (diet; exercise; diet and exercise) did not adversely affect the maternal and child health (article IV). The findings indicate the relevance of early identification of women at risk of excessive GWG. Health care providers should give women appropriate advice for controlling GWG and motivate them to lose pregnancy-related weight during postpartum. Additionally, health care providers should recommend women to engage in diet combined with physical activity programs in order to lose postpartum weight and consequently prevent obesity associated with childbearing.O objetivo desta tese é avaliar o impacto do estilo de vida materno no ganho de peso durante a gestação e na sua evolução durante o pós-parto. Inicialmente, foi realizada uma revisão da literatura sobre os indicadores utilizados para computar as mudanças de peso ocorridas durante a gestação e o pós-parto (artigo I). Posteriormente, utilizou-se o modelo de regressão logística para avaliar a associação entre a abstinência ao fumo durante o pré-natal e o ganho de peso gestacional (GPG) excessivo, segundo as recomendações do Institute of Medicine (IOM), em 1.249 mulheres que deram à luz a recém-nascidos vivos a termo em 1984/85 em Estocolmo, Suécia (artigo II). Em seguida, foi utilizado o modelo de regressão linear múltipla para avaliar o efeito do GPG excessivo no índice de massa corporal (IMC) materno 15 anos após o parto. A população elegível para análise foi constituída de 483 mulheres suecas, que foram acompanhadas desde o nascimento da criança índice em 1984/85 até 1999/2000 (artigo III). Por último, uma revisão sistemática com a utilização de metanálise foi realizada para apreciar o efeito da dieta, exercício ou ambos na perda de peso no pós-parto (artigo IV). A diversidade de indicadores utilizada para computar o GPG e a retenção de peso no pós-parto dificulta a interpretação e comparação dos resultados de pesquisas sobre o tema. A baixa qualidade dos registros obstétricos e a escolha inadequada do indicador são consideradas as possíveis causas da não associação entre o ganho de peso materno e os desfechos gestacionais encontrada em alguns estudos (artigo I). Ex-fumantes apresentam 1,8 vezes mais chance de GPG excessivo em relação às mulheres não fumantes, mesmo após o ajuste pelas variáveis de confusão, como o consumo de álcool, atividade física, entre outras (artigo II). Mulheres que tiveram GPG excessivo apresentaram maior retenção de peso 15 anos após parto (10,0 kg) do que as mulheres que ganharam peso conforme os limites recomendados pelo IOM (6,7 kg). Mesmo após o controle pelas variáveis de confusão, o GPG excessivo provocou um aumento significativo de 0,72 kg/m2 no IMC materno (artigo III). Mulheres aconselhadas a praticarem exercícios aeróbicos durante o pós-parto não perderam, significativamente, mais peso que as mulheres alocadas no grupo controle (diferença de média ponderada (DMP): 0,00; IC 95%: -8,63/ 8,63). Mulheres alocadas no grupo dieta (DMP: -1,70; IC 95%: -2,08/ -1,32) ou dieta e exercício (DMP: -2,89; IC 95%: -4,83/ -0,95) perderam, significativamente, mais peso que as mulheres alocadas no grupo controle. Nenhuma das estratégias de intervenção para perda de peso no pós-parto (exercício; dieta; dieta e exercício) provocou efeitos adversos à saúde materno-infantil (artigo IV). Os achados apontam para a importância da identificação precoce de mulheres sob-risco GPG excessivo. Os profissionais de saúde devem fornecer aconselhamento adequado durante o pré-natal para o controle do GPG e motivar as mulheres a perderem o peso retido durante o pós-parto. Assinala-se também que os profissionais de saúde devem recomendar programas de modificação do estilo de vida relacionados à dieta combinada ao exercício físico para perda de peso durante o pós-parto e, consequentemente, para a prevenção da obesidade associada ao ciclo reprodutivo.Submitted by Boris Flegr (boris@uerj.br) on 2020-08-02T16:53:05Z No. of bitstreams: 1 Amanda RodriguesAmorim-Tese.pdf: 7905481 bytes, checksum: eac13d60d3c9aaa446dfe299a1476f6a (MD5)Made available in DSpace on 2020-08-02T16:53:05Z (GMT). No. of bitstreams: 1 Amanda RodriguesAmorim-Tese.pdf: 7905481 bytes, checksum: eac13d60d3c9aaa446dfe299a1476f6a (MD5) Previous issue date: 2007-05-22application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBRCentro Biomédico::Instituto de Medicina SocialPregnancyPostpartumWeight controlLife styleGestaçãoPós-partoControle de pesoEstilo de vidaCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIAImpacto do estilo de vida no controle do peso durante a gestação e pós-partoImpact of lifestyle in weight control during pregnancy and postpartuminfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALAmanda RodriguesAmorim-Tese.pdfapplication/pdf7905481http://www.bdtd.uerj.br/bitstream/1/4672/1/Amanda+RodriguesAmorim-Tese.pdfeac13d60d3c9aaa446dfe299a1476f6aMD511/46722024-02-26 20:20:53.099oai:www.bdtd.uerj.br:1/4672Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:53Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
dc.title.alternative.eng.fl_str_mv |
Impact of lifestyle in weight control during pregnancy and postpartum |
title |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
spellingShingle |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto Amorim, Amanda Rodrigues Pregnancy Postpartum Weight control Life style Gestação Pós-parto Controle de peso Estilo de vida CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
title_short |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
title_full |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
title_fullStr |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
title_full_unstemmed |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
title_sort |
Impacto do estilo de vida no controle do peso durante a gestação e pós-parto |
author |
Amorim, Amanda Rodrigues |
author_facet |
Amorim, Amanda Rodrigues |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Lourenço, Paulo Mauricio Campanha |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3452686086840985 |
dc.contributor.referee1.fl_str_mv |
Coutinho, Evandro da Silva Freire |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/1020078557729775 |
dc.contributor.referee2.fl_str_mv |
Sichieri, Rosely |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/4204048575326745 |
dc.contributor.referee3.fl_str_mv |
Kac, Gilberto |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3138999292930429 |
dc.contributor.referee4.fl_str_mv |
Accioly, Elizabeth |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/1962760740425690 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4443418803788350 |
dc.contributor.author.fl_str_mv |
Amorim, Amanda Rodrigues |
contributor_str_mv |
Lourenço, Paulo Mauricio Campanha Coutinho, Evandro da Silva Freire Sichieri, Rosely Kac, Gilberto Accioly, Elizabeth |
dc.subject.eng.fl_str_mv |
Pregnancy Postpartum Weight control Life style |
topic |
Pregnancy Postpartum Weight control Life style Gestação Pós-parto Controle de peso Estilo de vida CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
dc.subject.por.fl_str_mv |
Gestação Pós-parto Controle de peso Estilo de vida |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
description |
The aim of this thesis is to evaluate the impact of maternal life style on gestational weight gain (GWG) and maternal weight development during postpartum. Firstly, an overview of the literature on indicators used to measure weight changes during and after pregnancy was carried out (article I). Secondly, a multivariate logistic regression model was used to assess the association between prenatal smoking cessation and excessive GWG, according to the Institute of Medicine (IOM) recommendations, in 1.249 women who delivered a term infant in 1984/85 in Stockholm, Sweden (article II). Thirdly, a multivariate linear regression model was used to assess the effect of excessive GWG on maternal body mass index (BMI) at 15 years postpartum. The study population was composed of 483 Swedish women who were followed from delivery date of the index child in 1984/85 to 1999/2000 (article III). Finally, a systematic review with meta-analysis was conducted to appraise the effect of diet, exercise or both on postpartum weight loss (article IV). Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators used to calculate the GWG and postpartum weight retention. The reasons for non-significant associations between GWG and gestational outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute GWG (article I). Former smokers were 1,8 times more likely to gain excessive weight during pregnancy than nonsmokers, even after accounting for confounding factors, including alcohol consumption, physical activity to mention a few (article II). Postpartum weight retention at 15 years follow-up was higher among women who gained excessive weight during pregnancy (10,0 kg) than who gained weight according to IOM recommendations (6,7 kg). After accounting for confounding factors, women who gained excessive weight during pregnancy had a significant increase of 0.72 kg/m2 in BMI at 15 years follow-up compared to women who gained within recommendations (article III). Women who exercised did not significantly lose more weight than women in the control group (weighted mean difference (WMD) 0,00; 95% CI 8,63 to 8,63). Women who took part in a diet (WMD 1,70; 95% CI 2,08 to 1,32) or diet plus exercise (WMD 2,89; 95% CI 4,83 to 0,95) program lost significantly more weight than women in the control group. The interventions (diet; exercise; diet and exercise) did not adversely affect the maternal and child health (article IV). The findings indicate the relevance of early identification of women at risk of excessive GWG. Health care providers should give women appropriate advice for controlling GWG and motivate them to lose pregnancy-related weight during postpartum. Additionally, health care providers should recommend women to engage in diet combined with physical activity programs in order to lose postpartum weight and consequently prevent obesity associated with childbearing. |
publishDate |
2007 |
dc.date.issued.fl_str_mv |
2007-05-22 |
dc.date.available.fl_str_mv |
2014-05-06 |
dc.date.accessioned.fl_str_mv |
2020-08-02T16:53:05Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
AMORIM, Amanda Rodrigues. Impacto do estilo de vida no controle do peso durante a gestação e pós-parto. 2007. 161 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2007. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/4672 |
identifier_str_mv |
AMORIM, Amanda Rodrigues. Impacto do estilo de vida no controle do peso durante a gestação e pós-parto. 2007. 161 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2007. |
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http://www.bdtd.uerj.br/handle/1/4672 |
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UERJ |
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BR |
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Centro Biomédico::Instituto de Medicina Social |
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Universidade do Estado do Rio de Janeiro |
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