Janne Boone-Heinonen, Dang Dinh, Rachel Springer, Shuling Liu, Jean O'Malley, Natalie A. Rosenquist, Teresa Schmidt, Jonathan M. Snowden, Sarah-Truclinh Tran, Kimberly K. Vesco
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引用次数: 0
摘要
研究目的本研究的目的是根据孕前体重指数（BMI）分类，估计特定孕期体重增加（GWG）对胎龄偏小和胎龄偏大（与适当胎龄相比）（即 SGA、LGA 和 AGA）的影响：我们对全国社区医疗机构网络中的孕妇进行了一项队列研究，按照孕前体重指数进行分层（正常体重 20676 人；超重 19156 人；肥胖 I 级 11647 人；肥胖 II 级 5124 人；肥胖 III 级 3197 人）。使用改良泊松回归法，将 SGA 和 LGA（与 AGA 相比）作为孕期 1、2 或 3 的 GWG 率、前三个孕期的 GWG 率和产妇特征的函数进行建模：GWG率从体重下降到大幅增加不等。GWG-LGA 的关联性在怀孕三个月中最强（不同 BMI 类别中，GWG 第 10 百分位数与第 50 百分位数的风险比 [RR] 范围为 0.60-0.73）：0.60-0.73).孕前体重正常、肥胖 I 级和肥胖 III 级的 GWG-SGA 相关性分别为 1.62、1.40 和 1.17，II 级和 III 级呈曲线相关：结论：在孕前肥胖等级为 II 级或 III 级的人群中，GWG 率与较高的 LGA 风险呈剂量依赖关系，其中包括未被充分研究的体重减轻范围，但与 SGA 的关系不大。
Trimester-specific rate of gestational weight loss or gain and birth size: differences by prepregnancy BMI
Objective
The objective of this study was to estimate the effects of trimester-specific gestational weight gain (GWG) on small and large (compared with appropriate) for gestational age (i.e., SGA, LGA, and AGA) by prepregnancy BMI classifications.
Methods
We conducted a cohort study of pregnancies in a national network of community health care organizations, stratifying by prepregnancy BMI (n = 20,676 with normal weight; 19,156 with overweight; 11,647 with obesity class I; 5124 with obesity class II; and 3197 with obesity class III). SGA and LGA (vs. AGA) were modeled as a function of trimester 1, 2, or 3 GWG rate, previous trimester(s) GWG rate, and maternal characteristics using modified Poisson regression.
Results
GWG rates ranged from weight loss to substantial gains. GWG-LGA associations were strongest in trimester 1 (risk ratio [RR] range for 10th vs. 50th percentile GWG, across BMI categories: 0.60–0.73). GWG-SGA associations were strongest in lower BMI categories and in trimester 2; RRs were 1.62, 1.40, and 1.17 for prepregnancy normal weight, obesity class I, and obesity class III, respectively, with curvilinear associations for class II and III.
Conclusions
Among people with prepregnancy obesity class II or III, GWG rate is associated with higher LGA risk in a dose-dependent manner, including understudied ranges of weight loss, but with weak associations with SGA.
期刊介绍：
Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.
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