Pre-pregnancy body mass index (BMI) and maternal gestational weight gain are positively associated with birth outcomes in rural Malawi.
Pre-pregnancy body mass index (BMI) and maternal gestational weight gain are positively associated with birth outcomes in rural Malawi.
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DOI：
10.1371/journal.pone.0206035
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Jorgensen JM
中科院分区：
文献类型：
--
作者：
Gondwe A;Ashorn P;Ashorn U;Dewey KG;Maleta K;Nkhoma M;Mbotwa J;Jorgensen JM
尽管孕前和孕期孕产妇营养状况不佳与不良分娩结局广泛相关，但在低收入国家量化这种关联的研究很少。我们研究了马拉维农村孕妇孕前体重指数（BMI）和孕期体重增加是否与分娩结果相关。我们分析了孕前BMI与平均每周妊娠体重增加（WWG）和出生结局[妊娠持续时间、出生体重、年龄长度z评分（LAZ）和头围年龄z评分（HCZ）]之间的关系。我们还确定了孕前BMI低或高或WWG不足或过高的妇女是否会增加不良分娩结局的风险。分析纳入1287名平均BMI为21.8 kg/m2的女性，其中5.9%体重不足（< 18.5 kg/m2）， 10.9%超重（≥25 kg/m2）， 71.8%的WWG低[低于医学研究所（IOM）推荐的下限]，5.2%的WWG高（高于IOM推荐）。在调整后的模型中，孕前BMI与妊娠持续时间无关（p = 0.926），但与出生体重和HCZ呈正相关（分别<0.001和p = 0.003）。WWG与妊娠期（p = 0.031）、出生体重（p<0.001）、LAZ （p<0.001）、HCZ （p<0.001）呈正相关。与正常体重的妇女相比，体重过轻的妇女生育发育迟缓婴儿的风险增加（p = 0.029）。与体重增加正常的妇女相比，低WWG的妇女生下低出生体重（p = 0.006）和头围小（p = 0.024）婴儿的风险增加。那些高BMI或高WWG的人没有增加不良出生结局的风险。WWG是马拉维农村出生结果的重要预测指标。与低孕前BMI相比，WWG不足的高患病率突出了调查该地区体重增加不足原因的必要性。
Whereas poor maternal nutritional status before and during pregnancy is widely associated with adverse birth outcomes, studies quantifying this association in low income countries are scarce. We examined whether maternal pre-pregnancy body mass index (BMI) and weight gain during pregnancy are associated with birth outcomes in rural Malawi. We analyzed the associations between pre-pregnancy BMI and average weekly gestational weight gain (WWG) and birth outcomes [duration of gestation, birth weight, length-for-age z-score (LAZ), and head circumference-for-age z-score (HCZ)]. We also determined whether women with low or high pre-pregnancy BMI or women with inadequate or excessive WWG were at increased risk of adverse birth outcomes. The analyses included 1287 women with a mean BMI of 21.8 kg/m2, of whom 5.9% were underweight (< 18.5 kg/m2), 10.9% were overweight (≥ 25 kg/m2), 71.8% had low WWG [below the lower limit of the Institute of Medicine (IOM) recommendation], and 5.2% had high WWG (above IOM recommendation). In adjusted models, pre-pregnancy BMI was not associated with duration of pregnancy (p = 0.926), but was positively associated with birth weight and HCZ (<0.001 and p = 0.003, respectively). WWG was positively associated with duration of gestation (p = 0.031), birth weight (p<0.001), LAZ (p<0.001), and HCZ (p<0.001). Compared to normal weight women, underweight women were at increased risk of having stunted infants (p = 0.029). Women with low WWG were at increased risk of having infants with low birth weight (p = 0.006) and small head circumference (p = 0.024) compared to those with normal weight gain. Those with high BMI or high WWG were not at increased risk of adverse birth outcomes. WWG is an important predictor of birth outcomes in rural Malawi. The high prevalence of inadequate WWG compared to low pre-pregnancy BMI highlights the need to investigate causes of inadequate weight gain in this region.
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影响因子：
2.9
作者：
Pan Y;Zhang S;Wang Q;Shen H;Zhang Y;Li Y;Yan D;Sun L
通讯作者：
Sun L
影响因子：
2.8
作者：
El Rafei, Rym;Abbas, Hussein A.;Yunis, Khalid A.
通讯作者：
Yunis, Khalid A.
DOI：
10.1186/1477-7827-9-6
发表时间：
2011-01-18
期刊：
Reproductive biology and endocrinology : RB&E
影响因子：
--
作者：
Choi SK;Park IY;Shin JC
通讯作者：
Shin JC
DOI：
10.2471/blt.10.077982
发表时间：
2011-02-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Ota, Erika;Haruna, Megumi;Yanai, Hideki
通讯作者：
Yanai, Hideki
影响因子：
7.1
作者：
Ashorn, Per;Alho, Lotta;Maleta, Kenneth
通讯作者：
Maleta, Kenneth