Patterns of Gestational Weight Gain in Women with Overweight or Obesity and Risk of Large for Gestational Age
Patterns of Gestational Weight Gain in Women with Overweight or Obesity and Risk of Large for Gestational Age
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超重或肥胖女性的妊娠体重增加模式以及大于胎龄的风险
DOI：
10.1159/000500748
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发表时间：
2019-01-01
期刊：
影响因子：
3.6
通讯作者：
Zhang, Weiyuan
中科院分区：
文献类型：
--
作者：
Zheng, Wei;Huang, Wenyu;Zhang, Weiyuan
目的：妊娠期体重增加（GWG）的时间可能对围产期结局产生不同的影响。本研究旨在发现超重或肥胖妇女潜在GWG模式与大于胎龄儿（LGA）风险的相关性。方法：共4，438名超重或肥胖的妇女被纳入分析。通过轨迹分析确定了与LGA相关的GWG的潜在轨迹。比较各组间的GWG、LGA风险和早孕因素。结果如下：这项研究确定了四个不同的GWG轨迹组与LGA，每组包括，分别为78.6%，19.0%，1.4%和0.9%的参与者。第1组呈典型的曲线，早期妊娠GWG较低，中晚期妊娠GWG相对较高。第2组妇女的GWG和LGA患病率持续高于第1组妇女（48.24%对21.56%，p < 0.0001）。与第1组相比，第3组在低体重增加后追赶GWG并没有导致显著更高的LGA风险。另一方面，在妊娠的前三分之二快速GWG，随后严格控制体重，与第1组相比，第4组中LGA的风险升高（62.50 vs. 21.56%，p < 0.0001）。结论：超重或肥胖合并妊娠早期高GWG的妇女发生LGA的风险增加。早期临床识别不良GWG轨迹将有助于对高危人群进行早期干预。
Objective: Timing of gestational weight gain (GWG) may influence perinatal outcomes differently. This study aimed to find associations of latent GWG patterns with risk of large for gestational age (LGA) in women with overweight or obesity. Methods: A total of 4,438 women with overweight or obesity were included in the analyses. Latent trajectories of GWG associated with LGA were identified by trajectory analysis. GWG, risk of LGA and early pregnancy factors were compared between these identified groups. Results: This study identified four distinct GWG trajectory groups associated with LGA, each group including, respectively, 78.6, 19.0, 1.4, and 0.9% of the participants. Group 1 presented a typical curve with lower GWG in early pregnancy and relatively higher GWG in mid- and late pregnancy. Women in group 2 showed sustained high GWG and high LGA prevalence than women in group 1 (48.24 vs. 21.56%, p < 0.0001). A catch-up in GWG after low weight gain did not result in significantly higher risk of LGA in group 3 compared to group 1. On the other hand, a rapid GWG in the first two-thirds of pregnancy followed by a strict weight control was associated with elevated risk of LGA in group 4 than group 1 (62.50 vs. 21.56%, p < 0.0001). Conclusions: Women affected by overweight or obesity combined with high GWG in early mid-pregnancy were at elevated risk of LGA. Early clinical recognition of a poor GWG trajectory will enable early intervention in high-risk groups.