Dynamic energy-balance model predicting gestational weight gain
Dynamic energy-balance model predicting gestational weight gain
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DOI：
10.3945/ajcn.111.024307
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发表时间：
2012-01-01
影响因子：
7.1
通讯作者：
Butte, Nancy F.
中科院分区：
文献类型：
--
作者：
Thomas, Diana M.;Navarro-Barrientos, Jesus E.;Butte, Nancy F.
背景资料：超过2009年医学研究所推荐范围的孕期体重增加（GWG）增加了长期产后体重保持的风险;相反，在推荐范围内的GWG更有可能导致积极的母婴结局。尽管有这一证据，最近的流行病学研究表明，大多数孕妇获得的目标GWG范围之外。一个数学模型，预测GWG和能量摄入量可以提供一个临床工具，设定精确的目标，在怀孕早期和持续的目标反馈整个pregnancy.Objective：本研究的目的是开发和验证一个微分方程模型的能量平衡在怀孕期间，预测GWG的结果，从能量摄入量的变化。设计：一组预测GWG的孕前BMI依赖性数学模型是通过使用一项纵向研究的数据开发的，该研究测量了63名受试者的无脂肪质量、脂肪质量、总身体水分和总能量消耗的妊娠变化。为孕前BMI低、正常和高的妇女开发的数学模型与原始数据相符。在2个独立的研究用于验证，模型预测的无脂肪质量，脂肪质量，和总的身体水分匹配的实际测量1公斤内。结论：我们的能量平衡模型提供了合理的预测GWG的结果，从能量摄入量的变化。由于该模型是作为一个基于Web的小程序实现的，它可以被孕妇和他们的医疗保健提供者广泛使用。美国临床营养杂志2012;95：115-22。
Background: Gestational weight gains (GWGs) that exceed the 2009 Institute of Medicine recommended ranges increase risk of long-term postpartum weight retention; conversely, GWGs within the recommended ranges are more likely to result in positive maternal and fetal outcomes. Despite this evidence, recent epidemiologic studies have shown that the majority of pregnant women gain outside the target GWG ranges. A mathematical model that predicts GWG and energy intake could provide a clinical tool for setting precise goals during early pregnancy and continuous objective feedback throughout pregnancy.Objective: The purpose of this study was to develop and validate a differential equation model for energy balance during pregnancy that predicts GWG that results from changes in energy intakes.Design: A set of prepregnancy BMI-dependent mathematical models that predict GWG were developed by using data from a longitudinal study that measured gestational-changes in fat-free mass, fat mass, total body water, and total energy expenditure in 63 subjects.Results: Mathematical models developed for women with low, normal, and high prepregnancy BMI were shown to fit the original data. In 2 independent studies used for validation, model predictions of fat-free mass, fat mass, and total body water matched actual measurements within 1 kg.Conclusions: Our energy-balance model provides plausible predictions of GWG that results from changes in energy intakes. Because the model was implemented as a Web-based applet, it can be widely used by pregnant women and their health care providers. Am J Clin Nutr 2012;95:115-22.