Diet and lifestyle interventions in postpartum women in China: study design and rationale of a multicenter randomized controlled trial.

Wei Bao,Shuang Wu,Mei Xiao,Liegang Liu,Nanping Wang,Wei Yang,Yingying Ouyang,Yanting Zhao,Limei Mao,Jianqiang Lai,Guoqiang Sun,Aiguo Ma,Juan Fu

doi:10.1186/1471-2458-10-103

Abstract

Background"Doing the month", or "sitting month", is a traditional practice for postpartum women in China and other Asian countries, which includes some taboos against well-accepted healthy diet and lifestyles in general population. Previous studies have shown this practice may be associated with higher prevalence of postpartum problems. The current multicenter randomized controlled trial (RCT) aims to evaluate outcomes of diet and lifestyle interventions in Chinese postpartum women.Methods/DesignThe current multicenter RCT will be conducted in three representative areas in China, Shandong province, Hubei province and Guangdong province, which locate in northern, central and southern parts of China, respectively. Women who attend routine pregnancy diagnosis in hospitals or maternal healthcare centers will be invited to take part in this study. At least 800 women who meet our eligibility criteria will be recruited and randomly assigned to the intervention group (n > = 400) and the control group (n > = 400). A three-dimension comprehensive intervention strategy, which incorporates intervention measures simultaneously to individual postpartum woman, their family members and community environment, will be utilized to maximize the effectiveness of intervention. Regular visiting and follow-up will be done in both group; nutrition and health-related measurements will be assessed both before and after the intervention.DiscussionTo our knowledge, this current study is the first and largest multicenter RCT which focus on the effectiveness of diet and lifestyle intervention on reducing the incidence rate of postpartum diseases and improving health status in postpartum women. We hypothesize that the intervention will reduce the incidence rates of postpartum diseases and improve nutrition and health status due to a balanced diet and reasonable lifestyle in comparison with the control condition. If so, the results of our study will provide especially important evidence for changes in both the concept and action of traditional postpartum practice in China.Trial RegistrationClinicalTrials.gov ID NCT01039051.

Highlights

The postpartum period, or puerperium, which starts about an hour after the delivery of the placenta and includes the following six weeks, covers a critical transitional time for a woman, her newborn and her family, on a physiological, emotional and social level
To our knowledge, this current study is the first and largest multicenter randomized controlled trial (RCT) which focus on the effectiveness of diet and lifestyle intervention on reducing the incidence rate of postpartum diseases and improving health status in postpartum women
We hypothesize that the intervention will reduce the incidence rates of postpartum diseases and improve nutrition and health status due to a balanced diet and reasonable lifestyle in comparison with the control condition

Summary

Introduction

The postpartum period, or puerperium, which starts about an hour after the delivery of the placenta and includes the following six weeks, covers a critical transitional time for a woman, her newborn and her family, on a physiological, emotional and social level. Women who are “doing the month” are advised to lie in bed all the time with doors and windows closed, and consume plenty of eggs or meat, drink bowels of chicken soup, brown sugar water, and millet gruel every day, while avoid eating any raw and cold food (mainly refers to fruits, vegetables), because cold food were thought to be unfavorable for postpartum recovery [8,9,10] This practice seems to be believed more or less by almost all Chinese population worldwide, rather than only by local people in China mainland. We found that 18% of women never ate vegetables, 78.8% never ate fruit and 75.7% never drank milk during the puerperium while, in contrast, the consumption of eggs and brown sugar were as high as 365.0 g/d and 81.3 g/d in rural postpartum women, which is associated with postpartum problems including constipation, backaches, breast problems, oral diseases and anemia, et al [15]

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