Association of Timing of Weight Gain in Pregnancy With Infant Birth Weight
Association of Timing of Weight Gain in Pregnancy With Infant Birth Weight
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DOI：
10.1001/jamapediatrics.2017.4016
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发表时间：
2018-02-01
期刊：
影响因子：
26.1
通讯作者：
Walker, Mark C.
中科院分区：
文献类型：
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作者：
Retnakaran, Ravi;Wen, Shi Wu;Walker, Mark C.
重要性 妊娠期体重增加是婴儿出生体重的决定因素，但尚不清楚妊娠期体重增加是否会在这方面产生影响。先前的研究对于孕早期母亲体重增加与出生体重之间的关系得出了相互矛盾的结果。然而，由于这些研究通常招募妊娠早期的女性，因此它们本质上受到对自我报告的孕前体重的依赖的限制。 目的 评估直接测量的母亲孕前体重以及随后怀孕期间体重增加的时间与婴儿出生体重之间的关联。 设计、设置和参与者在这项前瞻性、孕前、观察性队列研究中，中国浏阳市的 1164 名新婚女性接受了孕前评估，中位数为单胎妊娠前 19.9 周，他们进行了一系列体重测量。该研究于2009年2月1日至2015年11月4日进行。数据分析于2016年9月1日至2017年5月6日期间进行。暴露计算以下10个妊娠间隔的母亲体重增加：从怀孕前到小于14、14至18、19至23、24至28、29至30、 31 至 32、33 至 34、35 至 36、37 至 38 和 39 至 40 周。主要结果和测量 孕前体重和 10 个妊娠间隔内体重增加与婴儿出生体重结果的关联。 结果 参与研究的 1164 名女性的平均 (SD) 年龄为 25.3 (3.1) 岁。孕前体重与婴儿出生体重始终相关。然而，在10个妊娠间隔中，只有孕前至14周和14至18周的体重增加与出生体重相关。从孕前到 14 周，母亲体重增加了 13.6 g/kg（95% CI，3.2-24.1 g/kg），从 14 周到 18 周，母亲体重增加了 26.1 g/kg（95% CI，3.8-48.4 g/kg）。 结论和相关性 仅在妊娠前半期母亲体重是婴儿的决定因素出生体重。怀孕前和妊娠早期可能是干预影响随后出生体重的关键窗口期。
IMPORTANCE Gestational weight gain is a determinant of infant birth weight, but it is unclear whether its timing in pregnancy may hold implications in this regard. Previous studies have yielded conflicting findings on the association of maternal weight gain in early pregnancy with birth weight. However, as these studies have typically recruited women during the first trimester, they are inherently limited by a reliance on self-reported pregravid weight.OBJECTIVE To evaluate the associations of directly measured maternal pregravid weight and the timing of subsequent weight gain across pregnancy with infant birth weight.DESIGN, SETTING, AND PARTICIPANTS In this prospective, preconception, observational cohort study, 1164 newly married women in Liuyang, China, underwent pregravid evaluation at a median of 19.9 weeks before a singleton pregnancy during which they underwent serial weight measurements. The study was conducted from February 1, 2009, to November 4, 2015. Data analysis was performed between September 1, 2016, and May 6, 2017.EXPOSURE Maternal weight gain was calculated for the following 10 gestational intervals: from pregravid to less than 14, 14 to 18, 19 to 23, 24 to 28, 29 to 30, 31 to 32, 33 to 34, 35 to 36, 37 to 38, and 39 to 40 weeks. MAIN OUTCOMES AND MEASURES Associations of pregravid weight and weight gain within each of the 10 gestational intervals with the outcome of infant birth weight.RESULTS The mean (SD) age of the 1164 women included in the study was 25.3 (3.1) years. Pregravid weight was consistently associated with infant birth weight. However, among the 10 gestational intervals, only weight gain from pregravid to 14 weeks and from 14 to 18 weeks was associated with birth weight. Birth weight increased by 13.6 g/kg (95% CI, 3.2-24.1 g/kg) of maternal weight gain from pregravid to 14 weeks and by 26.1 g/kg (95% CI, 3.8-48.4 g/kg) of maternal weight gain from 14 to 18 weeks.CONCLUSION AND RELEVANCE Maternal weight only in the first half of gestation is a determinant of infant birth weight. Before pregnancy and early gestation may be a critical window for intervention to affect subsequent birth weight.