Patterns of gestational weight gain related to fetal growth among women with overweight and obesity.
Patterns of gestational weight gain related to fetal growth among women with overweight and obesity.
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DOI：
10.1002/oby.21006
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发表时间：
2015-05
期刊：
影响因子：
6.9
通讯作者：
Hubel, Carl
中科院分区：
文献类型：
--
作者：
Catov, Janet M.;Abatemarco, Diane;Althouse, Andrew;Davis, Esa M.;Hubel, Carl
母亲肥胖与大于胎龄儿(LGA)和小于胎龄儿(SGA)的出生风险增加有关。两者都与儿童肥胖症有关。我们认为，妊娠期体重增加(GWG)的模式可能有助于消除这些相互竞争的风险。在一组超重或肥胖的女性(n=651)中，GWG的模式具有特征。多分类Logistic回归模型检验GWG模式和出生体重结果之间的关联：SGA(<；10)和LGA(>；90%)。SGA的发生率(14.9%)高于LGA(7.8%)。确定了四种GWG模式：持续高(29%)、早期充足/晚期高(33%)、持续充足(18%)和持续低(20%)。持续高GWG的女性发生LGA的风险最高(调整后的优势比[OR]4.62[1.53，13.96])，在早期充足/晚期高收益的女性中，风险增加，但幅度较小(OR 3.07[1.01，9.37])。20周前高GWG，无论以后增重如何，均与LGA相关。20周前的低增益和随后的高增益可能与降低SGA风险相关(0.55[0.29，1.07])。孕期体重增加的模式可能是超重和肥胖妇女胎儿异常生长的重要因素或标志。
Maternal obesity is associated with increased risk of large-for-gestational-age (LGA) and small-for-gestational-age (SGA) births. Both are related to childhood obesity. We considered that patterns of gestational weight gain (GWG) may help to disentangle these competing risks. Patterns of GWG were characterized among a cohort of overweight or obese women (n=651). Polytomous logistic regression models tested for associations between GWG patterns and birthweight outcomes: SGA (<10th) and LGA (>90th percentile). Rates of SGA were higher than those for LGA (14.9% vs. 7.8%). Four GWG patterns were identified: consistently high (29%), early adequate/late high (33%), consistently adequate (18%), and consistently low (20%). Risk of LGA was highest in women with consistently high GWG (adjusted odds ratio [OR] 4.62 [1.53, 13.96]), and risk was elevated, but with lower magnitude, among women with early adequate/late high gains (OR 3.07 [1.01, 9.37]). High GWG before 20 weeks, regardless of later gain, was related to LGA. Low gain before 20 weeks accompanied by high gain later may be associated with reduced SGA risk (0.55 [0.29, 1.07]). The pattern of weight gain during pregnancy may be an important contributor to or marker of abnormal fetal growth among overweight and obese women.
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