Classifying Gestational Weight Gain Trajectories Using the SITAR Growth Model.
Classifying Gestational Weight Gain Trajectories Using the SITAR Growth Model.
复制标题
使用 SITAR 生长模型对妊娠体重增加轨迹进行分类。
DOI：
10.1111/ppe.12336
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发表时间：
2017
影响因子：
2.8
通讯作者：
Hutcheon,JenniferA
中科院分区：
文献类型：
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作者：
Riddell,CorinneA;Platt,RobertW;Bodnar,LisaM;Hutcheon,JenniferA
研究背景孕期增重通常以孕期增重的总量为特征，然而，增重的模式可能是健康结果的重要决定因素。SITAR（翻译和旋转的超级施加）模型已被用来描述儿童的成长轨迹，并有吸引力，因为其参数的生物学解释。本研究的目的是确定应用此模型的可行性妊娠期体重增加trajectors.MethodsThe研究队列包括3470正常体重，超重，肥胖的妇女提供Magee妇女医院在匹兹堡，宾夕法尼亚州，1998年至2010年。我们将SITAR模型（一种非线性混合效应模型）应用于每个孕前体重指数（BMI）类别的连续产前体重增加测量。我们适合不同复杂性的模型，并选择最佳拟合模型来描述每个BMI group.ResultsThe最复杂的SITAR模型无法收敛的模式的体重增加（由其绝对量，时间，和加速度），但减少模型可以成功地通过指定更少的随机效应和简化胎龄建模。每个BMI组的最佳拟合模型解释了95%至97%的体重增加轨迹变化。体重增加的峰值率达到第20和第22周之间，并高于正常和超重的妇女（0.59公斤/周和0.57公斤/周，分别）比肥胖妇女（0.46公斤/周）。
BackgroundGestational weight gain is often characterized by the total amount of weight gained during pregnancy, however, the pattern of gain may be an important determinant of health outcomes. The SITAR (Super Imposition by Translation And Rotation) model has been used to describe childhood growth trajectories and has appeal because of the biological interpretability of its parameters. The objective of this study was to determine the feasibility of applying this model to gestational weight gain trajectories.MethodsThe study cohort included 3470 normal‐weight, overweight, and obese women delivering at Magee‐Womens Hospital in Pittsburgh, Pennsylvania, 1998 to 2010. We applied the SITAR model, a non‐linear mixed effects model, to serial prenatal weight gain measurements in each pre‐pregnancy body mass index (BMI) category. We fit models of varying complexity, and chose the best‐fitting model to describe the pattern of weight gain (by its absolute amount, timing, and acceleration) for each BMI group.ResultsThe most complex SITAR models failed to converge, but reduced models could successfully be fit by specifying fewer random effects and simplifying the modelling of gestational age. Best‐fitting models for each BMI group explained between 95% and 97% of the variation in weight gain trajectories. Peak rates of weight gain were reached between the 20th and 22nd weeks, and were higher for normal and overweight women (0.59 kg/week and 0.57 kg/week, respectively) than obese women (0.46 kg/week).ConclusionsFollowing some modifications, the SITAR model can be used to characterize pregnancy weight gain patterns.