Self-reported Pre-pregnancy Weight Versus Weight Measured at First Prenatal Visit: Effects on Categorization of Pre-pregnancy Body Mass Index
Self-reported Pre-pregnancy Weight Versus Weight Measured at First Prenatal Visit: Effects on Categorization of Pre-pregnancy Body Mass Index
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DOI：
10.1007/s10995-012-1210-9
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发表时间：
2013-12-01
影响因子：
2.3
通讯作者：
Waring, Molly E.
中科院分区：
文献类型：
--
作者：
Holland, Erica;Simas, Tiffany A. Moore;Waring, Molly E.
比较使用自我报告的孕前体重与首次产前访视时测量的体重进行的孕前体重指数（BMI）分类。在马萨诸塞州三级保健中心的产科诊所接受产前护理的307名妇女的回顾性队列研究。2007年4月至2008年3月期间，符合条件的妇女在怀孕14周之前开始产前护理，并分娩了单胎婴儿。平均而言，自我报告的体重比第一次产前检查时测量的体重轻4磅（SD 7.2磅;范围：轻19磅至重35磅）。使用自我报告的孕前体重来计算孕前BMI，4.2%的女性体重不足，48.9%体重正常，25.4%超重，21.5%肥胖。使用第一次产前检查时测量的体重，这些分别为3.6%，45.3%，26.4%和24.8%。87%的女性的妊娠前BMI分类一致（加权kappa = 0.86; 95%CI 0.81-0.90）。女性在怀孕期间平均增加32.1磅（SD 18.0磅）。在13%的BMI分类不一致的样本中，74%的人在将体重增加与医学研究所的建议进行比较时，在相同的依从性类别中获得了体重增加。对于绝大多数妇女来说，自我报告的孕前体重和第一次产前检查时测量的体重导致孕前BMI的分类相同。在没有测量的孕前体重的情况下，我们建议提供者计算这两个值，并与他们的怀孕患者讨论差异，因为在怀孕的前三个月体重显著减轻或增加可能表明需要额外的监督和潜在的干预。
To compare classification of pre-pregnancy body mass index (BMI) using self-reported pre-pregnancy weight versus weight measured at the first prenatal visit. Retrospective cohort of 307 women receiving prenatal care at the faculty and resident obstetric clinics at a Massachusetts tertiary-care center. Eligible women initiated prenatal care prior to 14 weeks gestation and delivered singleton infants between April 2007 and March 2008. On average, self-reported weight was 4 pounds lighter than measured weight at the first prenatal visit (SD 7.2 pounds; range: 19 pounds lighter to 35 pounds heavier). Using self-reported pre-pregnancy weight to calculate pre-pregnancy BMI, 4.2 % of women were underweight, 48.9 % were normal weight, 25.4 % were overweight, and 21.5 % were obese. Using weight measured at first prenatal visit, these were 3.6, 45.3, 26.4, and 24.8 %, respectively. Classification of pre-pregnancy BMI was concordant for 87 % of women (weighted kappa = 0.86; 95 % CI 0.81-0.90). Women gained an average of 32.1 pounds (SD 18.0 pounds) during pregnancy. Of the 13 % of the sample with discrepant BMI classification, 74 % gained within the same adherence category when comparing weight gain to Institute of Medicine recommendations. For the vast majority of women, self-reported pre-pregnancy weight and measured weight at first prenatal visit resulted in identical classification of pre-pregnancy BMI. In absence of measured pre-pregnancy weight, we recommend that providers calculate both values and discuss discrepancies with their pregnant patients, as significant weight loss or gain during the first trimester may indicate a need for additional oversight with potential intervention.