The bias in current measures of gestational weight gain.
The bias in current measures of gestational weight gain.
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DOI：
10.1111/j.1365-3016.2011.01254.x
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发表时间：
2012-03
影响因子：
2.8
通讯作者：
Platt RW
中科院分区：
文献类型：
--
作者：
Hutcheon JA;Bodnar LM;Joseph KS;Abrams B;Simhan HN;Platt RW
传统的妊娠体重增加(GWG)指标，如平均体重增加速度，可能与妊娠持续时间相关。这种相关性可能会对GWG的流行病学研究和不良围产期结局带来偏见，因为许多围产期结局也与孕期相关。这项研究旨在量化目前使用的GWG测量方法可能在多大程度上偏离母亲体重增加和早产风险之间的明显关系。对于各省围产期数据库中的每名妇女(加拿大不列颠哥伦比亚省，2000-2009年)，模拟了总的GWG，使其与早产风险无关。该模拟是基于对足月妊娠样本进行的一系列产前GWG测量。用3种方法对模拟GWG进行分类：总体重增加(Kg)、平均体重增加(kg/周)或妊娠体重增加是否符合医学研究所的建议，并用Logistic回归分析它们与早产≤32周的关系。GWG的所有测量结果都表明，GWG与早产≤之间存在明显的关联，32周时，尽管设计上并不存在这种关联。每项GWG测量中最低五分之一与中间五分之一相比的优势比从4.4[95%可信区间3.6，5.4](总体重增加)到1.6[95%可信区间1.3，2.0](医学研究所充分率)。GWG的传统测量方法给母亲体重增加和早产的研究带来了严重的偏差。需要一种与妊娠持续时间无关的新的GWG测量方法。
Conventional measures of gestational weight gain (GWG), such as average rate of weight gain, are likely correlated with gestational duration. Such correlation could introduce bias to epidemiologic studies of GWG and adverse perinatal outcomes because many perinatal outcomes are also correlated with gestational duration. This study aimed to quantify the extent to which currently-used GWG measures may bias the apparent relation between maternal weight gain and risk of preterm birth. For each woman in a provincial perinatal database registry (British Columbia, Canada, 2000–2009), a total GWG was simulated such that it was uncorrelated with risk of preterm birth. The simulation was based on serial antenatal GWG measurements from a sample of term pregnancies. Simulated GWGs were classified using 3 approaches: total weight gain (kg), average rate of weight gain (kg/week) or adequacy of gestational weight gain in relation to Institute of Medicine recommendations, and their association with preterm birth ≤ 32 weeks was explored using logistic regression. All measures of GWG induced an apparent association between GWG and preterm birth ≤32 weeks even when, by design, none existed. Odds ratios in the lowest fifths of each GWG measure compared with the middle fifths ranged from 4.4 [95% CI 3.6, 5.4] (total weight gain) to 1.6 [95% CI 1.3, 2.0] (Institute of Medicine adequacy ratio). Conventional measures of GWG introduce serious bias to the study of maternal weight gain and preterm birth. A new measure of GWG that is uncorrelated with gestational duration is needed.
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影响因子：
4.3
作者：
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