Body mass index, provider advice, and target gestational weight gain
Body mass index, provider advice, and target gestational weight gain
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DOI：
10.1097/01.aog.0000152349.84025.35
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发表时间：
2005-03-01
影响因子：
7.2
通讯作者：
Escobar, GJ
中科院分区：
文献类型：
--
作者：
Stotland, NE;Haas, JS;Escobar, GJ
目的：研究孕前体重指数 (BMI)、女性目标妊娠体重增加和提供者体重增加建议之间的关系。 方法：WISH 项目（Women and Infants Starting Healthy 的缩写）是一项针对旧金山湾区孕妇的纵向队列研究。我们排除了患有早产、多胎妊娠或孕产妇糖尿病的受试者。 结果：在超重女性（怀孕前 BMI 26.1-29.0）中，24.1% 的女性报告目标体重增加高于医学研究所 (IOM) 指南，而正常体重女性的比例为 4.3% (P < .001)。在孕前 BMI 较低 (< 19.8) 的女性中，51.2% 的女性报告目标体重增加低于指南，而正常体重女性的比例为 10.4% (P < .001)。这些模式在多变量分析中仍然存在。拉丁裔种族、母亲受教育程度较低、孕前体重指数较低（< 19.8）、缺乏提供者关于体重增加的建议以及提供者建议体重增加低于指南均与低于 IOM 指南的目标体重增加独立相关。孕前 BMI 超过 26、多产、年龄较低以及提供者建议体重增加高于 IOM 指南均与高于 IOM 指南的目标增加相关。结论：女性对适当体重增加量的信念和提供者对体重增加的建议因母亲孕前 BMI 的不同而存在显着差异。许多女性报告了关于妊娠期体重增加的错误建议，而孕前体重指数高或低的女性更有可能有不正确的目标体重增加。需要新的提供者教育方法来实施 IOM 关于妊娠期体重增加的指南。
OBJECTIVE: To study the relationships among prepregnancy body mass index (BMI), women's target gestational weight gain, and provider weight gain advice.METHODS: Project WISH, the acronym for Women and Infants Starting Healthy, is a longitudinal cohort study of pregnant women in the San Francisco Bay area. We excluded subjects with preterm birth, multiple gestation, or maternal diabetes.RESULTS: Among overweight women (prepregnancy BMI 26.1-29.0), 24.1% reported a target weight gain above the Institute of Medicine (IOM) guidelines, compared with 4.3% of normal weight women (P < .001). Among women with a low prepregnancy BMI (< 19.8), 51.2% reported a target weight gain below the guidelines, compared with 10.4% of normal weight women (P < .001). These patterns persisted in a multivariate analysis. Latina ethnicity, lower maternal education, low prepregnancy BMI (< 19.8), lack of provider advice about weight gain, and provider advice to gain below guidelines were all independently associated with a target weight gain below IOM guidelines. Prepregnancy BMI more than 26, multiparity, lower age, and provider advice to gain above guidelines were all associated with a target gain above IOM guidelines.CONCLUSION: Women's beliefs about the proper amount of weight gain and provider recommendations for weight gain vary significantly by maternal prepregnancy BMI. Many women report incorrect advice about gestational weight gain, and women with high or low prepregnancy BMI are more likely to have an incorrect target weight gain. New approaches to provider education are needed to implement the IOM guidelines for gestational weight gain.