IMPROVEMENT OF THE COMPLEX OF MEASURES IN OVERWEIGHT WOMEN ON PRECONCEPTION PERIOD AND DURING PREGNANCY
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14265Keywords:
overweight women, preconception and antenatal care, inositol, insulin resistance, body fat mass, gestational weight gain, physical activity, lifestyleAbstract
This aim of the study – to evaluate the effectiveness of the complex of measures in overweight women on preconception period and during pregnancy.
Materials and Methods. The study involved 140 overweight women (body mass index (BMI) 25.0–29.9 kg/m2): 68 women (the first group) received generally accepted standard preconception and antenatal care recommendations, 72 women (comparison group) received the proposed preconception and antenatal care measures. Anthropometry was performed, BMI was calculated, eating behavior, physical activity level (PA), body fat mass percentage (% FM), serum glucose and insulin concentrations were determined, and the insulin resistance index (HOMA-IR) was calculated. The proposed program of measures included: 1) lifestyle modification (correction of eating behavior and FA, intensive walking (≥7500 steps/day); 2) multivitamin complex, an inositol complex (myo-inositol – 550 mg, D-chiro-inositol – 13.8 mg, folic acid - 240 mg), cholecalciferol (2000 IU per day prophylactic dose for vitamin D deficiency, 4000 IU per day for deficiency of vitamin D). Data was analyzed using Statistica 12.0 (StatSoft Inc., USA).
Results and Discusion. The implementation of the proposed program of measures has been contributed to an increase the frequency of women with a high degree of eating behavior (p<0.05), and moderate level of FA (p<0.05), a decrease the frequency of women with sedentary activity (p<0.05), an increase in the percentage of pregnant with ≥7500 steps/day in 2.7 times and a decrease of <5000 steps/day women in 4.0 times compared to the first group (p<0.05). In the comparison group at the prepregnancy period there was a decrease in % FM compared to the indicators at the beginning of the study (29.03±1.33 vs. 32.99±1.46, p<0.05), which correlated with a decrease in body weight (r=0.87, p<0.001). During pregnancy in this group, there was a decrease in the elevation of % FM and a 2.1 times higher percentage of pregnant was diagnosed with the recommended gestational weight gain (GWG) compared to the first group (p<0.05). A lower HOMA-IR indicator was established in the first trimester compared to the prepregnancy level (p<0.05), and its levels both at the beginning of gestation and before delivery were lower compared to the first group in 1.3 and 1.6 times, respectively (in both cases p<0.05).
Conclusions. So, it has been proven that the proposed program of measures for overweight women, supplemented by measures to regulate the level of eating behavior and physical activity with the inclusion of the myo-inositol/D-chiro-inositol complex, multivitamin complex, cholecalciferol, that started 3-6 months before the conception and continued during pregnancy, for the mother was associated with a decrease in the initial high level of insulin resistance with a significant reduced indicator until the end of pregnancy, which allows to prevent excessive accumulation of FM and excessive GWG.
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