Severe obesity, gestational weight gain, and adverse birth outcomes
Severe obesity, gestational weight gain, and adverse birth outcomes
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DOI：
10.3945/ajcn.2009.29008
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发表时间：
2010-06-01
影响因子：
7.1
通讯作者：
Abrams, Barbara
中科院分区：
文献类型：
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作者：
Bodnar, Lisa M.;Siega-Riz, Anna Maria;Abrams, Barbara
背景资料：2009年医学研究所（IOM）委员会重新评估了GEORGE体重增加指南，得出结论认为，根据肥胖严重程度提供体重增加指南的数据太少。因此，委员会建议所有肥胖妇女的体重范围为5-9 kg。目的：我们探讨了妊娠期体重增加与小于胎龄儿（SGA）出生、大于胎龄儿（LGA）出生、自发性早产（sPTB）和医学指征性早产（iPTB）之间的关系，这些肥胖妇女按肥胖严重程度分层。设计：我们研究了一组无先天性畸形的单胎活产婴儿，出生时肥胖等级为1（孕前体重指数[BMI（单位：kg/m2）。30-34.9; n = 3254）、2类（BMI：35-39.9; n = 1451）和3类（BMI：>= 40; n = 845）母亲。我们将妊娠期体重增加的充分性定义为观察到的体重增加与IOM推荐的妊娠期体重增加的比率。结果：随着肥胖的加重，妊娠期体重过度增加的患病率下降，体重减轻增加。一般来说，体重减轻与SGA、iPTB和sPTB的风险升高相关，体重增加倾向于增加LGA和iPTB的风险。与SGA和LGA概率相关的体重增加
Background: The 2009 Institute of Medicine (IOM) Committee to Reevaluate Gestational Weight Gain Guidelines concluded that there were too few data to inform weight-gain guidelines by obesity severity. Therefore, the committee recommended a single range, 5-9 kg at term, for all obese women.Objective: We explored associations between gestational weight gain and small-for-gestational-age (SGA) births, large-for-gestational-age (LGA) births, spontaneous preterm births (sPTBs), and medically indicated preterm births (iPTBs) among obese women who were stratified by severity of obesity.Design: We studied a cohort of singleton, live-born infants without congenital anomalies born to obesity class 1 (prepregnancy body mass index [BMI (in kg/m(2)).]: 30-34.9; n = 3254), class 2 (BMI: 35-39.9; n = 1451), and class 3 (BMI: >= 40; n = 845) mothers. We defined the adequacy of gestational weight gain as the ratio of observed weight gain to IOM-recommended gestational weight gain.Results: The prevalence of excessive gestational weight gain declined, and weight loss increased, as obesity became more severe. Generally, weight loss was associated with an elevated risk of SGA, iPTB, and sPTB, and a high weight gain tended to increase the risk of LGA and iPTB. Weight gains associated with probabilities of SGA and LGA of