Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth?
Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth?
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DOI：
10.1016/j.ajog.2014.02.004
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发表时间：
2014-08
影响因子：
9.8
通讯作者：
Tolosa, Jorge E.
中科院分区：
文献类型：
--
作者：
Catalano, Patrick M.;Mele, Lisa;Landon, Mark B.;Ramin, Susan M.;Reddy, Uma M.;Casey, Brian;Wapner, Ronald J.;Varner, Michael W.;Rouse, Dwight J.;Thorp, John M., Jr.;Saade, George;Sorokin, Yoram;Peaceman, Alan M.;Tolosa, Jorge E.
目的探讨超重和肥胖(O/O)孕妇孕期体重增加不足与胎儿生长发育的关系。对1053例O/O增加(14.4±6.2 kg)或188例≤下降或增加5 kg(1.1±4.4 kg)的预期单胎妊娠进行分析。用人体测量法测量出生体重、脂肪(FM)和瘦体重(Lm)。小于胎龄儿(≤)定义为美国标准人口的第10个百分位数。单变量和多变量分析评估了体重变化和新生儿形态测量之间的关系。在年龄、种族、吸烟、产次或孕周方面，两组之间没有显著差异。体重减轻或增加≤5 kg与SGA相关，18/188(9.6%)vs.51/1053(4.9%)(调整后OR2.6，95%CI 1.4，4.7；p=0.003)。≤减重或增加5 kg的新生儿出生体重(3258±443gvs 3467±492g，p<；0.0001)、FM(403±175vs.471±193g，p<；0.0001)、Lm(2855±321vs.2995±347g，p<；0.0001)、身长、Fm%和头围(HC)较小。调整糖尿病状况、孕前体重指数、吸烟、产次、研究地点、孕龄和性别；≤增加5 kg的新生儿出生体重、体质量、Fm、%Fm、Hc和身长显著降低。体重减轻和≤增加5公斤的新生儿结局没有显著差异。在O/O体重下降或增加时，≤5 kg与新生儿重度GA的风险增加、新生儿FM、LM和HC减少相关。
To evaluate inadequate gestational weight gain and fetal growth among overweight and obese women (O/O). Analysis of prospective singleton term pregnancies in which 1053 O/O gained greater (14.4± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1± 4.4 kg). Birth weight, fat (FM) and lean mass (LM) were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤ 10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry. There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤ 5 kg was associated with SGA, 18/188 (9.6%) vs. 51/1053 (4.9%); (adjusted OR 2.6, 95% CI 1.4, 4.7; p=0.003). Neonates of women who lost or gained ≤ 5 kg had lower birth weight (3258 ± 443 g vs. 3467 ± 492g, p<0.0001), FM (403±175 vs. 471 ± 193g, p<0.0001), LM (2855±321 vs. 2995 ± 347g, p<0.0001) and smaller length, %FM and head circumference (HC). Adjusting for diabetic status, pre-pregnancy BMI, smoking, parity, study site, gestational age and gender; neonates of women who gained ≤ 5 kg had significantly lower birth weight, LBM, FM, %FM, HC and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤ 5 kg. In O/O weight loss or gain ≤ 5 kg is associated with increased risk of SGA and decreased neonatal FM, LM and HC.
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