Antepartum bed rest: maternal weight change and infant birth weight.
Antepartum bed rest: maternal weight change and infant birth weight.
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DOI：
10.1177/1099800403260307
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发表时间：
2004-01-01
影响因子：
2.5
通讯作者：
Park, Seunghee
中科院分区：
文献类型：
--
作者：
Maloni, Judith A;Alexander, Greg R;Park, Seunghee
尽管缺乏有效性的证据，但美国的产科医生每年为70多万名妇女开出产前卧床休息的处方。然而，在非妊娠样本中，卧床休息治疗产生体重减轻。本研究评估了产前住院卧床治疗期间母亲体重的变化（增加）;比较了婴儿出生体重与胎龄、种族和性别的适当性;并确定母亲体重变化是否可预测婴儿出生体重。这项纵向研究的便利样本包括141名接受医院卧床休息治疗的高危妊娠妇女。每周怀孕体重变化率的体重指数与医学研究所的建议怀孕体重增加率进行了比较。将婴儿出生体重与当前美国婴儿出生体重进行比较，以匹配胎龄，性别和种族。产前每周体重变化明显低于医学研究所的建议（P < 0.001）。当每个婴儿的胎龄、种族和性别匹配时，婴儿出生体重也显著低于全国平均值（P < 0.001）。母亲体重变化预测婴儿出生体重（P = 0.05）。卧床休息治疗对改善妊娠期体重增加无效。所有胎龄的婴儿出生体重较低表明，母亲在卧床休息期间体重减轻可能与胎儿生长受限的风险增加有关。需要进行一项随机试验，比较卧床与非卧床的高危妊娠妇女，以确定卧床治疗、基础母胎疾病或两者是否影响母体体重增加不足和宫内发育不良。
Despite lack of evidence for effectiveness, obstetricians in the United States prescribe antepartum bed rest for more than 700,000 women per year. However, in nonpregnant samples, bed rest treatment produces weight loss. This study assessed maternal weight change (gain) during antepartum hospitalization for bed rest treatment; compared appropriateness of infant birth weights for gestational age, race, and gender; and determined whether maternal weight change predicted infant birth weight. The convenience sample for this longitudinal study consisted of 141 women with high-risk pregnancies who were treated with hospital bed rest. Weekly rate of pregnancy weight change by body mass index was compared with Institute of Medicine recommendations for rate of pregnancy weight gain. Infant birth weight was compared with current US infant birth weights for matching gestational age, gender, and race. Weekly antepartum weight change was significantly lower than Institute of Medicine recommendations (P < 0.001). Infant birth weights were also significantly lower than the national mean when matched for each infant's gestational age, race, and gender (P < 0.001). Maternal weight change predicted infant birth weight (P = 0.05). Bed rest treatment is ineffective for improving pregnancy weight gain. Lower infant birth weights across all gestational ages suggest that maternal weight loss during bed rest may be associated with an increased risk of fetal growth restriction. A randomized trial comparing women with high-risk pregnancies who are ambulatory with those on bed rest is needed to determine whether bed rest treatment, underlying maternal-fetal disease, or both influence inadequate maternal weight gain and poor intrauterine growth.