The Effect of Gestational Weight Gain by Body Mass Index on Maternal and Neonatal Outcomes
The Effect of Gestational Weight Gain by Body Mass Index on Maternal and Neonatal Outcomes
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DOI：
10.1016/s1701-2163(16)34050-6
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发表时间：
2009-01-01
影响因子：
1.8
通讯作者：
Hutchens, Donna
中科院分区：
文献类型：
--
作者：
Crane, Joan M. G.;White, Joanne;Hutchens, Donna
目的：为了评估妊娠期体重增加对不同体重指数（BMI）classes.Methods的孕产妇和新生儿结局的影响：我们比较了体重不足，正常体重，超重，肥胖和病态肥胖（BMI >= 40.00）妇女妊娠期体重增加的基础上的孕产妇和新生儿结局。研究组是一个基于人群的队列，由2001年4月1日至2007年3月31日期间分娩的单胎妊娠妇女组成，来自纽芬兰和拉布拉多省围产期计划数据库。单因素分析和多因素Logistic回归分析（控制产妇年龄，产次，吸烟状况，伴侣状况，和胎龄）进行和优势比（OR）calculated.Results：只有30.6%的妇女获得了建议的体重量在怀孕期间，52.3%的妇女获得超过建议，17.1%获得低于建议。在孕前BMI正常的妇女中，体重过度增加与妊娠期高血压（OR 1.27; 95%CI 1.08-1.49）、分娩增加（OR 1.09; 95%CI 1.01-1.18）和出生体重≥ 4000 g（OR 1.21; 95%CI 1.10-1.34）的发生率增加相关。在超重妇女中，体重过度增加与妊娠期高血压（OR 1.31; 95%CI 1.10-1.55）和出生体重≥ 4000 g（OR 1.30; 95%CI 1.15-1.47）的发生率增加相关。在肥胖或病态肥胖的女性中，体重增加过多与出生体重≥ 4000 g（OR 1.20; 95%CI 1.07-1.34）和新生儿代谢异常（OR 1.31; 95%CI 1.00-1.70）的发生率增加相关。在病态肥胖女性中，体重增加不佳与硬膜外镇痛的使用较少相关（OR 0.34; 95%CI 0.12-0.95）。在体重正常、超重或肥胖的妇女中，推荐体重增加的妇女的不良结局（剖腹产、妊娠期高血压、出生体重< 2500 g or birth weight >≥ 4000 g）发生率低于体重过度增加的妇女。未产的病态肥胖妇女体重增加少，不良结局减少（OR 0.18，95%CI 0.04-0.83）。结论：妊娠期体重增加对妊娠结局的影响取决于妇女孕前BMI。超重和肥胖妇女的妊娠体重增加6.7-11.2公斤（15- 25磅），病态肥胖妇女的妊娠体重增加小于6.7公斤（15磅）与不良结局风险降低相关。
Objective: To evaluate the effects of gestational weight gain on maternal and neonatal outcomes in different body mass index (BMI) classes.Methods: We compared maternal and neonatal outcomes based on gestational weight gain in underweight, normal weight, overweight, obese, and morbidly obese (BMI >= 40.00) women. The study group was a population-based cohort of women with singleton gestations who delivered between April 1, 2001, and March 31, 2007, drawn from the Newfoundland and Labrador Provincial Perinatal Program Database. Univariate analyses and multivariate logistic regression analyses (controlling for maternal age, parity, smoking status, partnered status, and gestational age) were performed and odds ratios (ORs) were calculated.Results: Only 30.6% of women gained the recommended amount of weight during pregnancy; 52.3% of women gained more than recommended, and 17.1% gained less than recommended. In women with normal pre-pregnancy BMI, excess weight gain was associated with increased rates of gestational hypertension (OR 1.27; 95% CI 1.08-1.49), augmentation of labour (OR 1.09; 95% CI 1.01-1.18), and birth weight >= 4000 g (OR 1.21; 95% CI 1.10-1.34). In overweight women, excess weight gain was associated with increased rates of gestational hypertension (OR 1.31; 95% CI 1.10-1.55) and birth weight >= 4000 g (OR 1.30; 95% CI 1.15-1.47). In women who were obese or morbidly obese, excess weight gain was associated with increased rates of birth weight >= 4000 g (OR 1.20; 95% CI 1.07-1.34) and neonatal metabolic abnormality (OR 1.31; 95% CI 1.00-1.70). In morbidly obese women, poor weight gain was associated with less use of epidural analgesia (OR 0.34; 95% CI 0.12-0.95). In women who were of normal weight, overweight, or obese, the rate of adverse outcome (Caesarean section, gestational hypertension, birth weight < 2500 g or birth weight >= 4000 g) was lower in women with recommended weight gain than in those with excess weight gain. Adverse outcomes were reduced in nulliparous morbidly obese women who had poor weight gain (OR 0.18; 95% CI 0.04-0.83).Conclusion: The effects of gestational weight gain on pregnancy outcome depend on the woman's pre-pregnancy BMI. Pregnancy weight gains of 6.7-11.2 kg (15-25lb) in overweight and obese women, and less than 6.7 kg (15lb) in morbidly obese women are associated with a reduction in the risk of adverse outcome.