The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study.
The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study.
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DOI：
10.1186/1477-7827-9-6
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发表时间：
2011-01-18
期刊：
影响因子：
--
通讯作者：
Shin JC
中科院分区：
文献类型：
--
作者：
Choi SK;Park IY;Shin JC
本研究的目的是评估孕妇孕前体重指数（BMI）和妊娠期体重增加对韩国妇女围产期结局的影响。我们回顾性分析了2007年1月至2009年12月在首尔圣玛丽医院接受产前护理的2,454名妇女的医疗记录。我们使用世界卫生组织对亚洲人群的定义，包括体重不足（BMI < 18.5），正常（BMI等于或高于18.5且< 23），超重（BMI等于或高于23且< 25）和肥胖（BMI等于或高于25）。我们根据孕前BMI和妊娠期间体重增加分析围产期结局，并通过考虑母亲年龄、产次、胎儿数量、妊娠时间和病史，从多元Logistic回归模型计算校正的比值比（OR）和95%置信区间（CI）。在肥胖妇女中，妊娠期糖尿病、高血压疾病和宫颈内口功能不全的校正OR分别为4.46、2.53和3.70（95% CI = 2.63-7.59、1.26-5.07和1.50-9.12），巨大儿、低Apgar评分等新生儿并发症的校正OR值分别为2.08和1.98（95%CI分别为1.34-3.22和1.19-3.29）。然而，妊娠期体重增加和产科结局之间没有正线性关系。在正常体重的妇女中，孕妇和新生儿的并发症在怀孕期间体重增加不足时显著增加（分别为p < 0.0001和= 0.0180），我们在体重不足的妇女中观察到类似的结果（分别为p = 0.0136和0.0004）。这项研究表明，孕前超重和肥胖与不良产科结局的关系比孕期体重增加更密切。此外，怀孕期间体重增加不足可能导致严重的并发症。
The purpose of the study was to evaluate the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain on perinatal outcomes in a population of Korean women. We retrospectively reviewed the medical records of 2,454 women who had received antenatal care at Seoul St. Mary's Hospital from January 2007 to December 2009. We used World Health Organization definitions for Asian populations of underweight (BMI < 18.5), normal (BMI equal or higher 18.5 and < 23), overweight (BMI equal or higher 23 and < 25), and obese (BMI equal or higher 25). We analyzed perinatal outcomes according to the pre-pregnancy BMI and weight gain during pregnancy, and calculated the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression models by considering maternal age, parity, number of fetuses, length of gestation, and medical history. Among obese women, the adjusted ORs for gestational diabetes, hypertensive disorder, and incompetent internal os of cervix were 4.46, 2.53, and 3.70 (95% CI = 2.63-7.59, 1.26-5.07, and 1.50-9.12), respectively, and the adjusted ORs for neonatal complications such as macrosomia and low Apgar score were 2.08 and 1.98 (95% CI = 1.34-3.22 and 1.19-3.29), respectively, compared with normal weight women. However, there was no positive linear association between gestational weight gain and obstetric outcomes. In normal weight women, maternal and neonatal complications were significantly increased with inadequate weight gain during pregnancy (p < 0.0001 and = 0.0180, respectively), and we observed similar results in underweight women (p = 0.0136 and 0.0004, respectively). This study shows that pre-pregnancy overweight and obesity are more closely related to the adverse obstetric outcomes than excess weight gain during pregnancy. In addition, inadequate weight gain during pregnancy can result in significant complications.
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