Comparison of Gestational Weight Gain z-Scores and Traditional Weight Gain Measures in Relation to Perinatal Outcomes
Comparison of Gestational Weight Gain z-Scores and Traditional Weight Gain Measures in Relation to Perinatal Outcomes
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DOI：
10.1111/ppe.12168
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Abrams, Barbara
中科院分区：
文献类型：
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作者：
Bodnar, Lisa M.;Hutcheon, Jennifer A.;Abrams, Barbara
妊娠期体重增加(GWG)的传统测量方法与孕期相关，可能会导致对GWG和围产儿结局的研究产生偏差。孕妇孕期体重增加z分数图表是一种新工具，它允许将GWG总量归类为标准化的z分数，独立于妊娠持续时间。方法我们研究了2003年至2011年在宾夕法尼亚州分娩的正常体重(n=522120)和超重(n=237923)的活产单胎婴儿。GWG用胎龄标准化的Z评分和三个传统测量方法表示：总GWG(公斤)、GWG比率(每周孕期公斤)和GWG充分率(观察GWG/GWG由医学研究所推荐)。使用对数二项回归模型评估GWG与早产、小于胎龄儿和大胎龄儿之间的关系，同时调整种族/民族、教育程度、吸烟和其他混杂因素。结果GWG z得分与早产之间的关联近似为U型。与体重增加相关的早产风险
BackgroundConventional measures of gestational weight gain (GWG) are correlated with pregnancy duration, and may induce bias to studies of GWG and perinatal outcomes. A maternal weight-gain-for-gestational-age z-score chart is a new tool that allows total GWG to be classified as a standardised z-score that is independent of gestational duration. Our objective was to compare associations with perinatal outcomes when GWG was assessed using gestational age-standardised z-scores and conventional GWG measures.MethodsWe studied normal-weight (n=522120) and overweight (n=237923) women who delivered liveborn, singleton infants in Pennsylvania, 2003-11. GWG was expressed using gestational age-standardised z-scores and three traditional measures: total GWG (kg), rate of GWG (kg per week of gestation), and the GWG adequacy ratio (observed GWG/GWG recommended by the Institute of Medicine). Log-binomial regression models were used to assess associations between GWG and preterm birth, and small- and large-for-gestational-age births, while adjusting for race/ethnicity, education, smoking, and other confounders.ResultsThe association between GWG z-score and preterm birth was approximately U-shaped. The risk of preterm birth associated with weight gain