Should Gestational Weight Gain Recommendations be Tailored by Maternal Characteristics?
Should Gestational Weight Gain Recommendations be Tailored by Maternal Characteristics?
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DOI：
10.1093/aje/kwr064
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发表时间：
2011-07-15
影响因子：
5
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
作者测试了妊娠期体重增加（GWG）与5种不良妊娠结局（小于胎龄（SGA）出生、大于胎龄（LGA）出生、自发性早产、指示性早产和计划外剖宫产）之间的关系是否因母亲种族/民族、吸烟、产次、年龄和/或身高而异。他们还通过研究GWG和不同亚组中至少1种不良结局的风险，评估了GWG指南是否应针对特殊人群进行修改。数据来自2003年至2008年在宾夕法尼亚州匹兹堡的Magee-Womens医院分娩的23，362名正常体重的母亲。GWG的准确性定义为观察GWG除以推荐GWG。协同作用分析发现，吸烟，黑人种族/民族，产次，或低身高与不良GWG的组合与SGA出生的过度风险相关，而高GWG与这些特征中的每一个相结合，与相同GWG的女性相比，LGA出生的风险降低。然而，在2009年医学研究所推荐的GWG和最小化复合结局风险的GWG之间，至少1种不良结局的风险没有显著或有意义的差异。这些研究结果不支持GWG指导方针的基础上，一个母亲的吸烟状况，种族/民族，奇偶校验，年龄，或身高正常体重的妇女。
The authors tested whether the relation between gestational weight gain (GWG) and 5 adverse pregnancy outcomes (small-for-gestational-age (SGA) birth, large-for-gestational-age (LGA) birth, spontaneous preterm birth, indicated preterm birth, and unplanned cesarean delivery) differed according to maternal race/ethnicity, smoking, parity, age, and/or height. They also evaluated whether GWG guidelines should be modified for special populations by studying GWG and risk of at least 1 adverse outcome within different subgroups. Data came from a cohort of 23,362 normal-weight mothers who delivered singletons at Magee-Womens Hospital in Pittsburgh, Pennsylvania (2003-2008). Adequacy of GWG was defined as observed GWG divided by recommended GWG. The synergy analysis found that the combination of smoking, black race/ethnicity, primiparity, or short height with poor GWG was associated with an excess risk of SGA birth, while high GWG combined with each of these characteristics diminished risk of LGA birth in comparison with the same GWG among the women's counterparts. Nevertheless, there were no significant or meaningful differences in the risk of at least 1 adverse outcome between the GWG recommended by the Institute of Medicine in 2009 and the GWG that minimized risk of the composite outcome. These findings do not support the tailoring of GWG guidelines on the basis of a mother's smoking status, race/ethnicity, parity, age, or height among normal-weight women.