Gestational weight gain in 4 low- and middle-income countries and associations with birth outcomes: a secondary analysis of the Women First Trial.
Gestational weight gain in 4 low- and middle-income countries and associations with birth outcomes: a secondary analysis of the Women First Trial.
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DOI：
10.1093/ajcn/nqab086
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发表时间：
2021-08-02
期刊：
影响因子：
--
通讯作者：
Women First Preconception Trial Study Group
中科院分区：
文献类型：
--
作者：
Bauserman MS;Bann CM;Hambidge KM;Garces AL;Figueroa L;Westcott JL;Patterson JK;McClure EM;Thorsten VR;Aziz SA;Saleem S;Goldenberg RL;Derman RJ;Herekar V;Somannavar M;Koso-Thomas MW;Lokangaka AL;Tshefu AK;Krebs NF;Bose CL;Women First Preconception Trial Study Group
足够的妊娠期体重增加（GWG）对胎儿健康生长至关重要。然而，在营养不良普遍存在的低收入和中等收入国家，关于GWG以及如何通过营养状况和干预措施改变GWG的信息很少。我们描述GWG及其与胎儿生长和出生结局的关系。我们还研究了孕前BMI、孕前体重和早期体重增加对GWG的影响及其对胎儿生长的影响。这是对妇女第一次试验的二次分析，包括刚果民主共和国（DRC）、危地马拉、印度和巴基斯坦的2331名妇女，评价从入组到妊娠12周的体重增加和妊娠12周至32周的GWG速度（kg/wk）。根据母亲的BMI，将GWG速度的准确性与2009年医学研究所的建议进行比较。早期体重增加（EWG），GWG速度，GWG的充分性与出生结局使用线性和泊松模型。GWG速度（平均值± SD）因部位而异：刚果民主共和国为0.22 ± 0.15 kg/wk，巴基斯坦为0.30 ± 0.23 kg/wk，危地马拉为0.31 ± 0.14 kg/wk，印度为0.39 ± 0.13 kg/wk（P <0.0001）。母体GWG每增加0.1 kg/wk，出生身长增加0.13 cm（95% CI：0.07，0.18，P <0.001），出生体重增加0.032 kg（0.022，0.042，P <0.001）。与GWG不足的妇女相比，GWG充足的妇女分娩的新生儿平均身长和体重更高：47.98 ± 2.04 cm与47.40 ± 2.17 cm（P <0.001）和2.864 ± 0.425 kg与2.764 ± 0.418 kg（P <0.001）。基线BMI、EWG和GWG均与出生身长和体重相关。这些结果强调了孕妇在怀孕前和怀孕期间充分营养的重要性，这是改善胎儿生长的一个潜在的可改变因素。
Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions. We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth. This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, evaluating weight gain from enrollment to ∼12 weeks of gestation and GWG velocity (kg/wk) between ∼12 and 32 weeks of gestation. Adequacy of GWG velocity was compared with 2009 Institute of Medicine recommendations, according to maternal BMI. Early weight gain (EWG), GWG velocity, and adequacy of GWG were related to birth outcomes using linear and Poisson models. GWG velocity (mean ± SD) varied by site: 0.22 ± 0.15 kg/wk in DRC, 0.30 ± 0.23 in Pakistan, 0.31 ± 0.14 in Guatemala, and 0.39 ± 0.13 in India, (P <0.0001). An increase of 0.1 kg/wk in maternal GWG was associated with a 0.13 cm (95% CI: 0.07, 0.18, P <0.001) increase in birth length and a 0.032 kg (0.022, 0.042, P <0.001) increase in birth weight. Compared to women with inadequate GWG, women who had adequate GWG delivered newborns with a higher mean length and weight: 47.98 ± 2.04 cm compared with 47.40 ± 2.17 cm (P <0.001) and 2.864 ± 0.425 kg compared with 2.764 ± 0.418 kg (P <0.001). Baseline BMI, EWG, and GWG were all associated with birth length and weight. These results underscore the importance of adequate maternal nutrition both before and during pregnancy as a potentially modifiable factor to improve fetal growth.
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影响因子：
3.1
作者：
Hambidge KM;Krebs NF;Westcott JE;Garces A;Goudar SS;Kodkany BS;Pasha O;Tshefu A;Bose CL;Figueroa L;Goldenberg RL;Derman RJ;Friedman JE;Frank DN;McClure EM;Stolka K;Das A;Koso-Thomas M;Sundberg S;Preconception Trial Group
通讯作者：
Preconception Trial Group
影响因子：
3.7
作者：
Gondwe A;Ashorn P;Ashorn U;Dewey KG;Maleta K;Nkhoma M;Mbotwa J;Jorgensen JM
通讯作者：
Jorgensen JM
影响因子：
105.7
作者：
Ceesay, SM;Prentice, AM;Whitehead, RG
通讯作者：
Whitehead, RG
影响因子：
168.9
作者：
Black, Robert E.;Victora, Cesar G.;Uauy, Ricardo
通讯作者：
Uauy, Ricardo
影响因子：
2.1
作者：
Rasmussen, Kathleen M.;Catalano, Patrick M.;Yaktine, Ann L.
通讯作者：
Yaktine, Ann L.