Association of second and third trimester weight gain in pregnancy with maternal and fetal outcomes.
Association of second and third trimester weight gain in pregnancy with maternal and fetal outcomes.
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DOI：
10.1371/journal.pone.0054704
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Schmidt MI
中科院分区：
文献类型：
--
作者：
Drehmer M;Duncan BB;Kac G;Schmidt MI
调查根据2009年医学研究所（IOM/NRC）建议分类的妊娠中期和妊娠晚期每周体重增加与孕产妇和胎儿结局之间的相关性。在巴西妊娠糖尿病研究（Estudo Brasileiro do Diabetes Gestacional - EBDG）的2，244名孕妇中评估了妊娠体重增加。结局为剖宫产、早产和小于或大于胎龄儿（SGA、LGA）。通过调整孕前体重指数、孕期特定体重增加、年龄、身高、肤色、产次、教育程度、吸烟、饮酒、妊娠期糖尿病和妊娠期高血压疾病，使用稳健的泊松回归估计体重增加不足与结局之间的相关性。在完全校正的模型中，在妊娠中期，体重增加不足与SGA相关（相对风险[RR] 1.72，95%置信区间[CI] 1.26-2.33）和LGA的过度体重增加（RR 1.64，95% CI 1.16-2.31）;在妊娠晚期，体重过度增加与早产（RR 1.70，95% CI 1.08-2.70）和剖宫产（RR 1.21，95% CI 1.03-1.44）有关。妊娠中期体重增加少于推荐值的妇女与妊娠中期体重增加足够的妇女相比，剖宫产的风险较低（RR 0.82，95%CI 0.71-0.96）。虽然妊娠晚期体重增加不足与不良结局无关，但妊娠中期和妊娠晚期其他偏离推荐体重增加的情况与不良妊娠结局相关。这些调查结果部分支持了2009年国际移民组织/挪威难民理事会关于怀孕期间营养监测的建议。
To investigate the association between weekly weight gain, during the second and third trimesters, classified according to the 2009 Institute of Medicine (IOM/NRC) recommendations, and maternal and fetal outcomes. Gestational weight gain was evaluated in 2,244 pregnant women of the Brazilian Study of Gestational Diabetes (Estudo Brasileiro do Diabetes Gestacional – EBDG). Outcomes were cesarean delivery, preterm birth and small or large for gestational age birth (SGA, LGA). Associations between inadequate weight gain and outcomes were estimated using robust Poisson regression adjusting for pre-pregnancy body mass index, trimester-specific weight gain, age, height, skin color, parity, education, smoking, alcohol consumption, gestational diabetes and hypertensive disorders in pregnancy. In fully adjusted models, in the second trimester, insufficient weight gain was associated with SGA (relative risk [RR] 1.72, 95% confidence interval [CI] 1.26–2.33), and excessive weight gain with LGA (RR 1.64, 95% CI 1.16–2.31); in third trimester, excessive weight gain with preterm birth (RR 1.70, 95% CI 1.08–2.70) and cesarean delivery (RR 1.21, 95% CI 1.03–1.44). Women with less than recommended gestational weight gain in the 2nd trimester had a lesser risk of cesarean deliveries (RR 0.82, 95% CI 0.71–0.96) than women with adequate gestational weight gain in this trimester. Though insufficient weight gain in the 3rd trimester was not associated with adverse outcomes, other deviations from recommended weight gain during second and third trimester were associated with adverse pregnancy outcomes. These findings support, in part, the 2009 IOM/NRC recommendations for nutritional monitoring during pregnancy.
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影响因子：
7.2
作者：
Rode, Line;Hegaard, Hanne K.;Ottesen, Bent
通讯作者：
Ottesen, Bent
DOI：
10.1016/0002-9378(95)90598-7
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