孕前人体质量指数与妊娠高血压综合征的关系

目的 了解孕前人体质量指数(body mass index,BMI)与妊娠高血压综合征(pregnancy-induced hypertension,PIH)发生危险性之间的关系.方法 数据来自"中美预防出生缺陷和残疾合作项目"中嘉兴地区的围产保健监测数据库.研究对象为1995-2000年在嘉兴地区参加婚前或孕前体检且分娩了单胎活产儿的孕满20周的83 159名孕产妇.运用X2检验或X<,趋势>2检验比较不同BMI组或其他特征人群PIH发病率的差别,利用多元logistic回归分析孕前BMI与PIH发生危险性之间的关系.结果 PIH发病率为11.01%(9153/83 159;95%CI:10.79%～11.22%).PIH的发病率自BMI<18.5 kg/m2组的9.08%(1405/15 472;95%CI:8.63%～9.54%),18.5～22.9 kg/m2组的10.82%(6389/59 054;95%CI:10.57%～11.07%),23.0～24.9 kg/m2组的14.63%(943/6444;95%CI:13.78%～15.52%)升至BMI≥25/0 kg/m2组的19.00%(416/2189;95%CI:17.38%～20.71%),差异有统计学意义(X<,趋势>2=261.028,P=0.000).以BMI为18.5～22.9 kg/m2者为参照组,BMI<18.5 kg/m2、23.0～24.9 kg/m2和≥25.0 kg/m2组发生PIH的RR值分别为0.82(95%CI:0.77～0.87)、1.41(95%CI:1.31～1.52)和1.93(95%CI:1.73～2.16).调整地区、年龄、文化程度、职业、产次、产前检查次数和既往高血压病史或家族史后,上述RR值分别为0.85(95%CI:0.80～0.90)、1.37(95%CI:1.27～1.47)和1.88(95%CI:1.68～2.10).结论 PIH的发生危险随孕前BMI的升高而升高.     

孕前体重指数和孕期体重增加对大于胎龄儿和巨大儿发生风险的影响

目的:探讨孕前体重指数(BMI)和孕期体重增加对大于胎龄儿(LGA)和巨大儿发生风险的影响。方法:回顾性分析6562例次足月单胎分娩的孕妇孕前和孕期产检资料,按孕前BMI值分为偏瘦组(BMI18.5)、正常体重组(18.5≤BMI24.0)、超重组(24.0≤BMI27.0)和肥胖组(BMI≥27.0),分别计算4组孕妇在孕期体重不同程度增加的情况下发生LGA和巨大儿的相对风险值(OR)。结果:孕前BMI越高,孕期体重增加越多,分娩LGA和巨大儿的风险和比例越高。孕前偏瘦组的妇女,孕期体重增加超过18.0kg时,发生LGA的风险高于其他孕前BMI组;孕期体重增加超过25.0kg时,则发生LGA和巨大儿的风险均明显高于其他孕前BMI组。结论:孕前BMI和孕期体重增加过多均对LGA和巨大儿的发生有很大影响,应在保证营养的条件下,尽可能控制孕期体重的增加。     

孕前孕期体重与妊娠相关并发症及妊娠结局关系分析

目的探讨孕前和孕期体重与妊娠相关并发症及妊娠结局关系。方法选取我院2016年1月至2017年1月住院分娩的200例孕妇,根据BMI分为偏瘦组(BMI<18.5 kg/m~2)、正常组(18.5 kg/m~2≤BMI<24 kg/m~2)、超重组(BMI≥24 kg/m~2),根据孕妇的孕期体重增长值分为A组(△W<15 kg)、B组(15 kg≤△W≤20 kg)、C组(△W>20 kg)。比较不同孕前体重组、不同孕期体重增长组孕妇的妊娠相关并发症及妊娠结局。结果不同孕前体重组的妊娠期高血压、妊娠期糖尿病、巨大儿、新生儿窒息的发生率比较均有统计学差异(P<0.05);不同孕期体重增长组的妊娠期高血压、妊娠期糖尿病、巨大儿、新生儿窒息的发生率比较均有统计学差异(P<0.05)。结论孕妇孕前的最佳BMI应控制在18.5~24 kg/m~2,孕期体重增加应控制在7~15kg,建议孕妇合理膳食、适量运动,保持心态平衡,注意调整体重,从而有效降低妊娠相关并发症及不良妊娠结局的发生风险。     

孕期体重增长与巨大儿发生的随访数据分析研究

目的分析孕妇孕期体重增长对巨大儿发生的影响,为合理管理孕期体重提供参考依据。方法利用我国5个省区县监测点的孕妇孕晚期及儿童满月随访数据,招募孕晚期孕妇并填写孕晚期调查问卷,前瞻观察至孕妇分娩满1个月并填写新生儿满月调查问卷,问卷中儿童分娩孕周、出生体重、性别信息主要通过摘录医疗记录获取;根据是否发生巨大儿分为巨大儿组(192例)和对照组(2 405例),最终采用病例对照研究设计方法进行分析。采用χ~2检验或Fisher确切概率法比较两组差异,采用多因素Logistic回归模型分析孕期增重与巨大儿发生的关系;以孕前BMI为分层因素,进一步分析孕期增重与巨大儿发生的关系。结果本研究共随访孕产妇2 731例,随访率为100%。经数据清洗后纳入分析2 597例。控制孕妇年龄、孕妇文化程度、家庭年收入、妊娠期糖尿病、分娩孕周、新生儿性别协变量后,孕妇孕前超重或肥胖(OR=2.43, 95%CI:1.65～3.56)、孕期增重过多(OR=2.18, 95%CI:1.46～3.27)是巨大儿发生的独立危险因素;以孕前BMI为分层因素,进一步分析显示:孕前BMI正常(18.5 kg/m~2≤BMI 24.9 kg/m~2)的孕妇孕期增重过多(OR=2.07, 95%CI:1.27～3.37)、孕前超重或肥胖(BMI≥25.0 kg/m~2)的孕妇孕期增重过多(OR=2.63, 95%CI:1.07～6.47)均会增加巨大儿发生风险。结论孕期增重过多是巨大儿发生的独立危险因素,孕前体重正常但孕期增重过多,以及孕前超重或肥胖的人群孕期增重过多均会增加巨大儿发生的危险。     

单胎妊娠期孕妇足月时增重的临床范围研究

目的探讨单胎妊娠孕妇孕期适宜体质量增加范围。方法选择2009年1月-2013年10月在云南省大理州人民医院进行产前检查并分娩足月单胎活产的糖代谢正常孕妇3 892例作为研究对象。按美国医学研究院(IOM)2009年制定的不同孕前体质指数(BMI)标准分为3组:以BMI18.5 kg/m2定义为低BMI组;BMI18.5~24.9 kg/m2定义为正常BMI组;BMI≥25.0 kg/m2定义为高BMI组。新生儿出生体质量≥4 000 g为巨大儿;出生体质量2 500 g为低出生体质量儿;出生体质量2 500~4 000 g为正常出生体质量儿;以正常出生体质量2 500~4 000 g为适宜出生体质量。对各组孕妇资料进行统一录入,并进行回顾性分析。结果 3组孕妇中,低出生体质量儿的发生率均较低,其中低BMI组的发生率最高为2.39%,明显高于正常BMI组的0.70%(P0.01)。而三组中巨大儿的发生率却随着孕前BMI的增加而升高,其中高BMI组最高为8.87%,明显高于正常BMI组和低BMI组(P均0.01)。将2 500~4 000 g作为适宜新生儿出生体质量,通过百分位法计算出孕前低BMI、正常BMI及高BMI孕妇的适宜体质量增加范围分别为13.5~18.0 kg、12.5~16.5 kg和8.5~14.0 kg。以此范围为标准,将3 892例孕妇分为低于范围组、符合范围组和高于范围组,采用多分类Logistic回归分析法对母婴并发症风险进行评估结果显示,低于适宜体质量增加范围的孕妇分娩低出生体质量儿的风险有升高趋势(OR=2.86,95%CI为1.79~4.54,P=0.022),符合适宜体质量增加范围组的孕妇剖宫产风险降低(OR=0.09,95%CI为0.04~0.20,P0.01),高于适宜体质量增加范围组的孕妇发生妊娠期高血压疾病的风险升高(OR=4.81,95%CI为1.95~11.87,P0.01),剖宫产风险升高(OR=8.83,95%CI为2.76~28.25,P0.01),分娩巨大儿的风险也有所升高(OR=9.01,95%CI为1.01~81.76,P0.05)。结论我国单胎妊娠妇女孕前BMI18.5 kg/m2者孕期适宜体质量增加范围为13.5~18.0 kg,孕前BMI为18.5~24.9 kg/m2者孕期适宜体质量增加范围为12.5~16.5 kg,孕前BMI≥25.0 kg/m2者孕期适宜体质量增加范围为8.5~14.0 kg。     

孕前体重指数及其孕期增加对妊娠结局的影响

目的:定量评价孕前体重指数及孕期体重指数增加情况对我国北方孕妇妊娠结局的影响。方法:收集2007～2009年在沈阳3家医院分娩的3741名单胎妊娠初产妇,按照孕前体重指数(BMI)分为4组:低体重组(BMI18.5kg/m2)、正常体重组(18.5kg/m2≤BMI24kg/m2)、超重组(24kg/m2≤BMI28kg/m2)和肥胖组(BMI≥28kg/m2)。按照孕期BMI增加情况分为3组:A组(BMI增加4)、B组(BMI增加4～6)、C组(BMI增加6)。Logistic回归评估不良妊娠结局的危险度,结果用RR和95%CI表示。结果:①和正常体重组相比,孕前低体重、超重和肥胖组的孕妇患子痫前期的RR分别为0.53(95%CI0.29～0.97)、2.84(95%CI2.05～3.94)和5.35(95%CI3.47～8.49);患妊娠期糖尿病的RR分别为0.35(95%CI0.16～0.78)、3.40(95%CI2.44～4.75)和4.95(95%CI2.91～7.06);剖宫产和出生大于胎龄儿(LGA)的风险也随孕前体重的增加而增加。②和B组相比,C组增加了子痫前期(RR1.85,95%CI1.40～2.44)、妊娠期糖尿病(RR1.39,95%CI1.05～1.86)、剖宫产(RR1.37,95%CI1.15～1.63)及出生LGA(RR1.98,95%CI1.44～2.73)的相对危险性,但降低了出生SGA的风险。A组降低了子痫前期、剖宫产和出生LGA的风险,但增加了早产(34周)和出生SGA的风险。结论:孕前体重指数过高及孕期体重指数增加过度可以明显增加孕妇子痫前期、妊娠期糖尿病和剖宫产的风险。应加强健康教育,适度控制孕期体重,合理营养减少肥胖,对预防妊娠并发症,改善妊娠结局是有必要的。     

孕前体重指数和孕期体重增长与新生儿体重的关系

目的探讨孕妇孕前体重指数（bodymassindex,BMI）和孕期体重增长与新生儿体重的关系。方法2006年7月1日至2007年6月30日,2734例于四川I大学华西第二医院住院分娩且病历资料完整孕妇,按孕前体重指数分组。体重指数〈16．75kg／m2,纳入低BMI组（n=51）,体重指数为（16．75～23．71）kg／m2纳入正常BMI组（n=2330）,体重指数〉23．71kg／m2,纳入高BMI组（n=353）。根据四川大学华西第二医院推荐的孕期适宜体重增长模式,将孕期体重增长分为三类：体重增长〈13．13kg,体重增长为（13．13～20．25）kg和体重增长≥20．25kg。将正常BMI组与高BMI组孕妇分别按体重增长进一步分为三个亚组,分析孕妇孕前体重指数和孕期体重增长与新生儿体重的关系。结果低BMI组、正常BMI组和高BMI组孕妇孕前体重指数与新生儿体重的相关系数（r）分别为0．128（P〉0．05）,0．138（P〈0．01）和0．126（P〈0．05）。低BMI组、正常BMI组和高BMI组孕妇孕期体重增加与新生儿体重的相关系数分别为0．629（P〈0．001）,0．236（P〈0．001）和0．195（P〈0．001）。正常BMI组孕妇孕期体重增加〈13．13kg亚组1与正常BMI组体重增加为（13．13～20．25）kg亚组1比较,巨大儿发生的OR=0．617,95％CI：0．424～0．864（P〈0．01）。正常BMI组孕妇孕期体重增加〉20．25kg亚组1与体重增加为（13．13～20．25）kg亚组1比较,巨大儿发生的OR=1．622,95％CI：1．116～2．356（P〈0．01）。正常BMI组中,各体重增长亚组比较,低体重儿发生率差异无显著意义（P〉0．05）。高BMI组中,各体重增长亚组比较,低体重儿、巨大儿发生率差异无显著意义（P〉0．05）。结论孕妇孕前体重指数及孕期体重增加与新生儿出生体重呈正相关。为降低巨大儿发生率,正常体重指数组孕期体重增加不宜超过20．25kg。     

育龄期女性孕前体重及孕期体重增加与新生儿出生体重关系的回顾性队列研究

目的探讨育龄期女性孕前体重及孕期体重增加与新生儿出生体重的关系。方法选取2016年1月至2019年1月于北部战区总医院和平分院单胎分娩的产妇14 543例为研究对象,依据孕前体质量指数(body mass index,BMI)、孕期增重指南推荐体重增重值和新生儿出生体重情况进行分组。采用Logistic回归模型分析孕前BMI及孕期体重增加对新生儿出生体重的影响。结果①孕前不同BMI和孕期体重增加异常对新生儿出生体重结局有相关性,孕期体重增加不足和过多是早产儿[OR 1.30(95%CI:1.09-1.56)、2.45(95%CI:1.99-3.01)]和小于胎龄儿[OR 1.76(95%CI:1.13-2.48)、OR 2.14(95%CI:1.32-3.47)]出生风险高危人群。②孕期体重增加不足低体重孕妇,早产儿出生风险是正常体重孕妇2.77倍。而孕期体重增加过多的超重孕妇,早产儿出生风险是正常体重孕妇4.03倍。孕期体重增加适宜的超重孕妇,小于胎龄儿出生风险是正常体重孕妇2.62倍。③孕前低体重孕妇更容易发生孕期体重增加不足(OR 2.94,95%CI:2.30-3.75),孕前肥胖更容易导致孕期体重增加过多(OR 1.05,95%CI:0.94-1.61)。结论为合理控制孕前体重及孕期体重增长,减少新生儿不良结局发生,应将控制孕前体重及孕期体重增加作为孕前保健及围产期保健的重要内容,并根据孕前BMI制定个性化的营养计划。     

孕早期体重过低及孕期体重增加对分娩结局的影响

目的:探讨体重过低及孕期体重增加幅度对分娩结局的影响。方法:162例体重指数(BMI)<18.5的初产妇为体重过低组和377例BMI18.5～22.9的初产妇为标准体重组,进一步将体重过低组根据孕期体重增加幅度分为≥15kg和<15kg组,对比分析各组总产程时间、第一产程时间、产程异常率、剖宫产率、新生儿出生体重、早产率、新生儿窒息率。结果:体重过低组与标准体重组的产程时间、产程异常率、剖宫产率无统计学差异(P>0.05),体重过低组的早产率、新生儿窒息率显著高于标准体重组(P<0.05),新生儿出生平均体重低于标准体重组(P<0.05)。体重过低的初产妇孕期体重增加≥15kg其产程时间延长(P<0.01,P<0.05),产程异常率和剖宫产率高于<孕期体重增加15kg组(P<0.05),新生儿出生平均体重高于<孕期体重增加15kg组(P<0.05)。结论:①孕早期体重过低可能不增加异常产程的风险;②孕早期体重过低可影响新生儿出生体重,增加早产的风险;③体重过低的孕妇孕期体重增长过快可导致产程异常和手术产率增加。     

城乡324例孕妇周增重分析及对策研究

目的分析城乡不同孕前体重指数(BMI)孕妇每周体重增长的状况,找出存在的问题以制定相应的对策。方法选择天津市城市254例和农村70例孕妇为研究对象,对其不同孕前BMI(18.5、18.5~24.9、≥25 kg/m2)的孕妇周体重增长状况进行总结分析。结果不同孕前BMI孕妇孕期平均增重分别为17.80 kg、17.86 kg和14.92 kg,体重超重率达80%以上;3组孕前BMI城乡间无差别,早孕超重率25.30%,孕20~28周、28~32周平均体重增加最多。低体重组以20%~40%、适宜体重组以60%~70%、超重/肥胖组以70%~110%的方式递增,超出推荐的周体重。孕期增重致巨大儿发生率13.27%,城乡无差别;妊娠期糖尿病(GDM)发生率5.25%,城市高于农村(P0.01)。结论孕20~32周是脂肪聚集期,控制该阶段体重过度增长为孕期体重管理的切入点。     

High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women

BACKGROUND: An association between high prepregnant body mass index (BMI) and early termination of breastfeeding has been observed, but this finding may have depended on the sociocultural context. OBJECTIVE: The objective was to determine whether this association was stronger with increasing maternal obesity, was modified by gestational weight gain, and still existed when there was greater social support for breastfeeding. DESIGN: Study participants (37 459 women) were drawn from the Danish National Birth Cohort. The association of prepregnant BMI and gestational weight gain with the termination of full or any breastfeeding by 1, 16, or 20 wk postpartum was assessed with logistic regression analyses, and the risk of early termination of full and any breastfeeding during the first 18 mo postpartum was assessed with Poisson regression analyses. RESULTS: The risk of early termination of any (with similar results for full) breastfeeding rose progressively with increasing prepregnant BMI values (in kg/m(2)), from 1.12 (95% CI: 1.09, 1.16) for overweight (BMI = 25.0-29.9) women to 1.39 (95% CI: 1.19, 1.63) for obese class III women (BMI >or= 40) compared with normal-BMI women. Gestational weight gain did not add to or modify the association between prepregnant BMI and breastfeeding. CONCLUSIONS: These findings extend the observation to a broader range of BMIs that the greater the prepregnant BMI, the earlier the termination of breastfeeding. Together with the fact that this association was evident in a more supportive social context for breastfeeding, these findings suggest a biological basis for the association.     

Maternal obesity and the risk of infant death in the United States

BACKGROUND: Maternal obesity (defined as prepregnancy body mass index [BMI] >or=30 kg/m) is associated with increased risk of neonatal death. Its association with infant death, postneonatal death, and cause-specific infant death is less well-characterized. METHODS: We studied the association between maternal obesity and the risk of infant death by using 1988 US National Maternal and Infant Health Survey data. A case-control analysis of 4265 infant deaths and 7293 controls was conducted using SUDAAN software. Self-reported prepregnancy BMI and weight gain were used in the primary analysis, whereas weight variables in medical records were used in a subset of 4308 women. RESULTS: Compared with normal weight women (prepregnancy BMI = 18.5-24.9 kg/m) who gained 0.30 to 0.44 kg/wk during pregnancy, obese women had increased risk of neonatal death and overall infant death. For obese women who had weight gain during pregnancy of <0.15, 0.15 to 0.29, 0.30 to 0.44, and >or=0.45 kg/wk, the adjusted odds ratios of infant death were 1.75 (95% confidence interval = 1.28-2.39), 1.42 (1.07-1.89), 1.59 (1.00-2.51), and 2.87 (1.98-4.16), respectively. Nonobese women with very low weight gain during pregnancy also had a higher risk of infant death. The subset with weight information from medical records had similar results for recorded prepregnancy BMI and weight gain. Maternal obesity was associated with neonatal death from pregnancy complications or disorders relating to short gestation and unspecified low birth weight. CONCLUSIONS: Maternal obesity is associated with increased overall risk of infant death, mainly neonatal death.     

壮族地区孕前体质指数、孕期增重及孕期贫血对小于胎龄儿影响研究

目的 分析壮族地区小于胎龄儿（small for gestational age infants,SGA）发生情况,探讨孕妇孕前体质指数（body mass index,BMI）、孕期增重及孕期贫血等因素对发生SGA的影响,为更好地开展孕期保健指导提供依据。方法 选取2016年1~12月在广西平果县及隆安县的三家医院产科门诊首次产检、孕6~13周的2 199例单胎妊娠孕妇,收集孕妇的基本信息,并随访其产检记录、妊娠结局等信息。使用t检验、χ2检验和Logistic回归模型对调查数据进行分析。结果 SGA共327例,发生率为14.87%。调整混杂因素后,孕前BMI<18.5 kg/m2的孕妇比孕前BMI正常孕妇SGA发生风险增加1.09倍（OR=2.09,95%CI:1.59~2.75,P<0.001）,孕期体重增加不足孕妇比增加正常孕妇SGA发生风险增加1.19倍（OR=2.19,95%CI:1.67~2.86,P<0.001）,孕期轻、中重度贫血对SGA发生风险的影响差异均无统计学意义（均有P>0.05）。结论 孕前体质指数<18.5 kg/m2和孕期增重不足为该地区孕妇分娩SGA的危险因素。     

孕前体重指数及孕期增重对围生结局的影响

目的 分析孕前体重指数(BMI)及孕期体重增长对围生结局的影响,为孕期保健、孕前和孕期体重管理提供依据。方法 采用历史性队列研究方法,将深圳市龙岗区2014-2017年26家助产医院95 849例单胎足月产妇按孕前BMI及孕期增重情况分组,观察各组围生结局。结果 95 849例孕妇平均孕前BMI为(20.49±2.83) kg/m²,平均孕期增重(14.49±5.89) kg。相比孕前正常BMI 和孕期增重适宜的孕妇,孕前消瘦(BMI<18.5kg/m²)和孕期增重不足是低出生体重儿发生的危险因素,OR值(95%CI)分别为1.80(1.61~2.00)、1.83(1.63~2.05);孕前超重(BMI≥24 kg/m²)是妊娠期糖尿病(GDM)、妊娠期高血压、子痫前期/子痫、巨大儿、剖宫产、出生窒息发生的危险因素,OR值(95%CI)分别为1.84(1.68~2.02)、2.40(1.90~3.04)、3.07(2.39~3.96)、2.70(2.49~2.92)、1.89(1.81~1.97)及1.33(1.05~1.67);孕期增重过度是巨大儿、剖宫产、妊娠期高血压、子痫前期/子痫、胎膜早破、产后出血发生的危险因素,OR值(95%CI)分别为2.59(2.40~2.79)、1.45(1.40~1.50)、2.83(2.21~3.62)、2.18(1.69~2.81)、1.26(1.13~1.40)及1.26(1.07~1.48)。结论 孕前BMI和孕期增重均是剖宫产、妊娠期高血压、子痫前期/子痫、低出生体重和巨大儿发生的影响因素,因此将孕前BMI、孕期增重控制在合理范围有利于获得良好的围生结局。     

Dietary energy density but not glycemic load is associated with gestational weight gain

BACKGROUND: Most pregnant women gain more weight than the ranges recommended. Excessive weight gain is linked to pregnancy complications and to long-term maternal and child health outcomes. OBJECTIVE: The objective was to examine the impact of dietary glycemic load and energy density on total gestational weight gain and the weight gain ratio (observed weight gain/expected weight gain). DESIGN: Data are from 1231 women with singleton pregnancies who participated in the Pregnancy, Infection, and Nutrition Cohort Study. Dietary information was collected at 26-29 wk of gestation with the use of a semiquantified food-frequency questionnaire. Linear regression models were used to estimate the associations between quartiles of glycemic load and energy density with total gestational weight gain and weight gain ratio. RESULTS: Dietary patterns of pregnant women significantly differed across many sociodemographic and behavioral characteristics, with the greatest contrasts seen for glycemic load. After adjustment for covariates, compared with women in the first quartile consuming a mean dietary energy density of 0.71 kcal/g (reference), women in the third quartile consuming a mean energy density of 0.98 kcal/g gained an excess of 1.13 kg (95% CI: 0.24, 2.01), and women in the fourth quartile consuming a mean energy density of 1.21 kcal/g gained an excess of 1.08 kg (95% CI: 0.20, 1.97) and had an increase of 0.13 (95% CI: 0.006, 0.24) units in the weight gain ratio. All other comparisons of energy intakes were not statistically significant. Glycemic load was not associated with total gestational weight gain or weight gain ratio. CONCLUSION: Dietary energy density is a modifiable factor that may assist pregnant women in managing gestational weight gains.     

Trimester of Maternal Gestational Weight Gain and Offspring Body Weight at Birth and Age Five

To investigate associations of trimester-specific GWG with fetal birth size and BMI at age 5?years. We examined 3,015 singleton births to women without pregnancy complications from the Child Health and Development Studies prospective cohort with measured weights during pregnancy. We used multivariable regression to examine the associations between total and trimester gestational weight gain (GWG) and birth weight for gestational age and child BMI outcomes, adjusting for maternal age, race/ethnicity, education, marital status, parity, pre-pregnancy body mass index (BMI), and smoking; paternal overweight, gestational age, and infant sex. We explored differences in associations by maternal BMI and infant sex. GWG in all trimesters was significantly and independently associated with birth weight with associations stronger, though not significantly, in the second trimester. First trimester GWG was associated with child BMI outcomes (OR for child overweight?=?1.05; 95% CI?=?1.02, 1.09). Each kg of first trimester GWG was significantly associated with increased child BMI z-score in women of low (???=?0.099; 95% CI?=?0.034, 0.163) and normal (???=?0.028; 95% CI?=?0.012, 0.044), but not high pre-pregnancy BMI. GWG in all trimesters was associated with birth weight; only first trimester GWG was associated with child BMI. If replicated, this information could help specify recommendations for maternal GWG and elucidate mechanisms connecting GWG to child BMI.     

Television, walking, and diet: associations with postpartum weight retention

BACKGROUND: For many women, pregnancy begets long-term weight gain. Modifiable behaviors that contribute to postpartum weight retention have not been well studied. METHODS: Prospective cohort study of 902 women enrolled in Project Viva, examining associations of postpartum television viewing, walking, and trans fat intake with weight retention equal to or greater than 5 kg at 12 months postpartum. Data were collected in 1999-2003 and analyzed in 2005-2006. RESULTS: At 6 months postpartum, women reported a mean (SD) of 1.7 (1.3) hours of television viewing, 0.7 (0.7) hours of walking, and 1.1% (0.5) of energy intake from trans fat per day. At 1 year, participants retained a mean of 0.6 kg (range: -17.3 to 25.5), and 12% retained at least 5 kg. In multivariate logistic regression models, adjusting for maternal sociodemographics, parity, prepregnancy body mass index, gestational weight gain, breastfeeding, and smoking, the odds ratio of retaining at least 5 kg was 1.24 (95% confidence interval [CI]: 1.06-1.46) per daily hour of television viewing, 0.66 (95% CI: 0.46-0.94) per daily hour of walking, and 1.33 (95% CI: 1.09-1.62) per 0.5% increment in daily energy intake from trans fat. Women who watched less than 2 hours of television, walked at least 30 minutes, and consumed trans fat below the median had an odds ratio of 0.23 (95% CI: 0.08-0.66) of retaining at least 5 kg. CONCLUSIONS: Postpartum television viewing, walking, and trans fat intake were associated with weight retention. Interventions to modify these behaviors may help reduce excess postpartum weight gain and prevent obesity among women.     

孕前体质指数、孕期增重与婴幼儿血红蛋白的关系

目的 探讨孕前体质指数（body mass index,BMI）、孕期增重与婴幼儿血红蛋白的关系。方法 选择按期体检与分娩的孕妇及婴儿作为研究对象,孕妇一般情况及分娩情况将由问卷调查的方式收集。并采用单因素分析和多因素Logistic回归模型进行数据分析。结果 受检对象共980例,按孕前BMI分组,孕前消瘦者占19.0%,孕前体重正常者占71.0%,孕前超重肥胖者占10.0%。孕期增重按美国国家科学院（institute of medicine,IOM）标准分组,孕期增重低于IOM推荐标准者占27.8%,符合IOM推荐标准者占31.4%,高于IOM推荐标准者占40.8%。贫血发生率为49.7%。单因素分析中孕前BMI、孕期增重对贫血均有统计学意义（均有P<0.05）。同时多因素分析显示,孕前消瘦者（OR=2.027,95%CI:1.433～2.867）,孕期增重不足者（OR=2.499,95%CI:1.772～3.523）是婴幼儿贫血的危险因素。结论 孕前BMI、孕期增重情况可能是婴幼儿贫血的危险因素,控制孕前BMI、孕期增重情况可以有效降低贫血的发生风险。     

Nutritional indicators of adverse pregnancy outcomes and mother-to-child transmission of HIV among HIV-infected women

BACKGROUND: Poor nutrition may be associated with mother-to-child transmission (MTCT) of HIV and other adverse pregnancy outcomes. OBJECTIVE: The objective was to examine the relation of nutritional indicators with adverse pregnancy outcomes among HIV-infected women in Tanzania, Zambia, and Malawi. DESIGN: Body mass index (BMI; in kg/m(2)) and hemoglobin concentrations at enrollment and weight change during pregnancy were prospectively related to fetal loss, neonatal death, low birth weight, preterm birth, and MTCT of HIV. RESULTS: In a multivariate analysis, having a BMI < 21.8 was significantly associated with preterm birth [odds ratio (OR): 1.82; 95% CI: 1.34, 2.46] and low birth weight (OR: 2.09; 95% CI: 1.41, 3.08). A U-shaped relation between weight change during pregnancy and preterm birth was observed. Severe anemia was significantly associated with fetal loss or stillbirth (OR: 3.67; 95% CI: 1.16, 11.66), preterm birth (OR: 2.08; 95% CI: 1.39, 3.10), low birth weight (OR: 1.76; 95% CI: 1.07, 2.90), and MTCT of HIV by the time of birth (OR: 2.26; 95% CI: 1.18, 4.34) and by 4-6 wk among those negative at birth (OR: 2.33; 95% CI: 1.15, 4.73). CONCLUSIONS: Anemia, poor weight gain during pregnancy, and low BMI in HIV-infected pregnant women are associated with increased risks of adverse infant outcomes and MTCT of HIV. Interventions that reduce the risk of wasting or anemia during pregnancy should be evaluated to determine their possible effect on the incidence of adverse pregnancy outcomes and MTCT of HIV.