孕前体重孕期增重与新生儿出生体重的关系

目的 分析孕前体重、孕期增重与新生儿出生体重的关系,为降低低出生体重儿及巨大儿发生率提供科学依据。方法 根据孕前体重指数（Ｂｏｄｙ Ｍａｓｓ Ｉｎｄｅｘ,ＢＭＩ）将研究对象分为高体重、理想体重和低体重三组,分别计算平均出生体重和巨大儿、低出生体重儿发生率;进一步分组分析妇女的孕期不同增重与低出生体重儿及巨大儿发生的关系。结果 与理想休重组相比,高体重组巨大儿发生率较高（９．１％）,低体重组的低出生     

孕前体重指数及孕期体重增加对新生儿出生体重的影响

目的:探讨孕前体重指数(BMI)及孕期体重增加对新生儿出生体重的影响。方法:选取2012年1月至2012年8月于我院分娩的688例足月单胎产妇。按孕前BMI及孕期体重增加情况分别分组,比较各组的新生儿出生体重;按孕前BMI分组绘制折线图,观察巨大儿及低出生体重儿发生率的变化趋势。结果:孕前高体重组的新生儿出生体重显著高于低体重组与理想体重组(P0.01,P0.05),而后两组则无显著差异。孕期体重增长≥25kg组的新生儿出生体重显著高于15kg组及15kg~25kg组(P0.05),而后两组则无显著差异(P=0.973)。折线图显示,孕前低体重、理想体重及高体重组中巨大儿发生率曲线与低出生体重儿发生率曲线分别相交在孕期增重15~20kg、10~15kg和5~10kg。结论:根据孕前BMI科学控制孕期体重变化能有效降低巨大儿及低出生体重儿的发生率。     

妊娠期糖尿病孕妇孕前体重指数及孕期体重增长对新生儿出生体重的影响

妊娠期糖尿病 (GDM)是指妊娠期间首次发生或发现的糖代谢异常 [1 ] ,严重威胁母婴的健康。GDM的治疗首选饮食控制 [2 ] ,经饮食控制后 ,GDM孕妇的整个孕期体重增长如何 ,对新生儿体重有何影响 ,目前探讨得比较少。本研究对118例确诊为 GDM并经饮食控制治疗的孕妇进行回顾性分析 ,了解 GDM孕妇的孕前体重状况 ,评价 GDM孕妇的孕期体重增长 ,探讨影响 GDM新生儿出生体重的有关因素 ,为GDM的诊断与治疗提供有意义的参考。一、资料与方法1.资料来源 :1999年 1月至 2 0 0 1年 12月间 ,对在广州市妇婴医院产科门诊行常规检查 ,孕 2 4～ …     

孕前BMI及孕期增重对妇女产后两年体重变化的影响

目的:探讨孕前BMI及孕期增重对妇女产后2年体重变化的影响。方法:采用历史-前瞻性队列研究设计,选择合肥市某区妇幼保健站进行产后42天体检的418例妇女为研究人群并建立观察队列,采用问卷调查和查阅孕产妇管理档案的方法收集基线资料,于产后42天及6月、12月、18月、24月对其进行连续性随访观察各时点的体重值。结果:418例产妇产后42天、6月、12月、18月、24月恢复至孕前体重率分别为7.42%、15.38%、32.58%、24.89%、27.97%。孕前BMI各组(18.5kg/m2组,18.5kg/m2≤BMI24kg/m2组,≥24kg/m2组)产后各时点比较,差异均有统计学意义(P0.05)。孕期增重3组(孕期增重较少组、孕期增重适中组和孕期增重较多组)妇女产后42天、18月和24月体重变化值比较,差异均有统计学意义(P0.05)。结论:孕前BMI、孕期增重影响产后2年体重的变化,根据孕前BMI将孕期增重控制在合理范围内可有效促进妇女产后体重恢复到孕前水平并控制远期肥胖的发生。     

孕期体质指数增加与新生儿体重的关系

孕妇体重增加与胎儿生长发育及新生儿体重有密切关系。在研究了正常孕妇孕期体重增加模式的基础上 ,为进一步研究正常体质指数的孕妇在孕期中体质指数的增加与新生儿体重的关系 ,我们选择了 15 0 5例孕前至孕 12周时体质指数为正常的孕妇 (BMI:16 .75～2 3.71kg/ M2 ) [1 ]作为研究对象 ,分析研究这组孕妇体质指数的增加与新生儿体重间的关系。一、资料和方法1.资料来源 :1995年 1月 1日至1995年 12月 31日在本院进行产前检查、分娩的孕妇 ,资料完整 ,且在孕前至12周体质指数为正常的病例。孕妇身高及体重均由专业人员测定并登记 ,BMI计…     

上海地区妊娠期糖尿病孕妇孕前体重指数及孕期体重增加现状分析

目的:分析上海地区妊娠期糖尿病(GDM)孕妇孕前体重指数(BMI)和孕期增重(GWG)特点。方法:选取2017年7月至2018年7月在上海十家医院规律产检并住院分娩的单胎孕妇共3961例,其中610例GDM孕妇和3351例非GDM孕妇。分析GDM的发病高危因素,比较GDM孕妇和非GDM孕妇孕前BMI、GWG、早中晚孕期增重、妊娠合并症等差异,并将两组GWG与美国科学研究院医学协会(IOM)推荐增重标准进行比较。结果:孕前BMI和年龄是GDM发生的独立高危因素(OR=1.18,95%CI为1.05～1.34;OR=1.09,95%CI为1.06～1.11)。GDM组的孕前BMI值为(22.3±3.4)kg/m~2,高于NGDM组[(21.1±2.7)kg/m~2],两者差异有统计学意义(P0.05)。GDM组的GWG为(11.9±4.8)kg,明显低于NGDM组[(13.3±4.3)kg]。两组早孕期增重无统计学差异。GDM组的中、晚孕期增重[(5.5±2.4)kg、(4.1±2.4)kg]少于NGDM组孕妇[(6.5±2.7)kg、(4.8±2.5)kg],差异均有统计学意义(P均0.001)。与IOM推荐孕期增重标准比较,孕前BMI适中、超重的GDM组孕妇中增重偏少者占比均较NGDM组高;NGDM组增重偏多者占比均较GDM组高。结论:孕前超重或肥胖及高龄可导致GDM发生率增加,应对该群体进行孕前指导,合理控制BMI后再备孕。孕中晚期良好的医疗管理可有效控制GDM孕妇的孕期增重,进而减少不良妊娠结局。     

胎儿出生体重与孕期体重指数变化的相关性

目的 :探讨胎儿出生体重与孕期母亲体重指数的相关性。方法 :选择 2 0 0 2年 1月至 2 0 0 2年 10月在我院产前检查并分娩且无内科合并症及产科并发症的初产孕妇 190 0例 ,分别测量并计算孕前体重、分娩前体重、孕期体重变化及体重指数变化 ,采用偏相关分析胎儿出生体重与孕期体重指数的相关性。结果 :无论是控制身高、孕前体重还是控制孕期体重变化都发现胎儿出生体重与孕期体重指数的变化均呈正相关。结论 :胎儿出生体重与孕期体重指数的变化有较好的正相关性。     

孕前体质指数及孕期体重增长对妊娠过程及结局的影响

目的:探讨孕前体质指数(BMI)及孕期体重增长(GWG)与妊娠合并疾病及不良结局的关系。方法:回顾分析于复旦大学附属妇产科医院产科门诊定期产前检查并住院分娩的3541例足月单胎初产妇的临床资料。将产妇按孕前体质指数(BMI)和不同孕期体重增长(GWG)分组,采用logistic多因素回归分析孕前体质指数及孕期体重增长与妊娠合并疾病及结局的关系。结果:孕妇孕期体重平均增加(16.0±4.9)kg,新生儿平均出生体重(3341.6±425.9)g,低出生体重儿和巨大儿分别占2.1%及5.1%。根据IOM推荐孕期GWG分组,GWG过低、过高组孕妇与正常孕妇的巨大儿、剖宫产数、早产发生率比较,差异有统计学意义(P0.05)。孕前超重、肥胖能增加妊娠期糖尿病(OR=2.7,2.3)、妊娠期高血压疾病(OR=5.4,OR=7.7)、巨大儿(OR=1.6,OR=8.9)、剖宫产(OR=1.4,OR=1.7)的发生风险,而GWG过高增加剖宫产的发生风险(OR=1.5)。结论:孕前BMI不仅影响妊娠合并疾病的发生,也与妊娠结局密切相关。临床上应特别重视孕前宣教及体检,建议育龄期妇女达到合适的体质指数后怀孕。孕期过度体重增长增大了不良妊娠结局(巨大儿、剖宫产)的发生率,临床上可参照IOM推荐体重增长范围进行孕妇体重控制,加强孕期的健康教育和体重随访。同时建议利用大数据多方调研,得出适合中国各地区的孕期体重参考标准。     

西安市不同胎龄新生儿出生体重标准

出生体重标准曲线作为临床评价胎儿生长发育的依据在国外已广泛应用。为获得西安市城区新生儿出生体重标准 ,我们以西安市城区 1996～ 1999年间出生的新生儿为研究对象 ,在取得西安市城区不同胎龄新生儿出生体重经验百分位数的基础上 ,进行了出生体重标准的研究。一、资料和方法1.资料来源 :随机分层整群抽取西安市城区 1996～ 1999年度出生的活产、单胎、2 5～ 44周分娩的孕产妇系统管理资料 (包括新生儿资料 )共 1185 3例 ,占西安市城区年度活产数的 83.6 3%。排除新生儿出生缺陷者及母亲有妊娠合并症者 ,共分析 110 78例的资料。2 .方法 …     

足月新生儿出生体重与孕周相关性分析

目的：对新生儿出生体重与孕周的关系进行探讨,为孕期个性化管理提供依据。方法：随机选择孕妇分娩的足月单胎活产儿3884例,对其性别、出生体重和出生时的孕周等进行相关性分析。结果：新生儿的出生体重为3368.34±412.51g,最大值为5500g,最小值为1800g,不同性别的新生儿出生体重有显著差异,出生时不同孕周组的平均出生体重之间有显著性差异。在本组资料中低出生体重儿44例、巨大儿296例,其发生率分别为1.13%和7.6%,经卡方检验与出生时的孕周有密切关系。结论：出生时的孕周对新生儿的体重会产生一定的影响,因此,孕期的个性化管理非常必要。     

医学营养治疗对糖代谢异常妊娠期患者增重及新生儿出生体重的影响

目的 探讨医学营养治疗（MNT）对糖代谢异常妊娠期患者增重及新生儿出生体重的影响。方法 2005年5月至2005年10月对北京妇产医院诊断为糖代谢异常的单胎孕妇106例在产科营养门诊接受医学营养治疗，在进行总热量控制的基础上，使用等食品交换份结合血糖生成指数的方法，把同期未接受该方法而采用传统营养治疗方法的糖代谢异常孕妇96例作为对照组，比较两组孕妇的体重增长、体重指数（BMI）的增长及新生儿体重增长情况。结果 两组巨大儿的发生率分别为8．49％、13．54％，研究组巨大儿的发生率有所下降；两组比较孕妇妊娠期体重增长、每周体重增长、BMI增加、每周BMI增加差异均有显著性；新生儿体重有所下降，但差异无显著性。结论 对妊娠糖代谢异常患者进行科学、合理的营养治疗，妊娠期体重增加明显减少，新生儿体重在合适范围，对孕妇妊娠期体重增长的管理有提示作用。     

Inadequate gestational weight gain contributes to increasing rates of low birth weight in Taiwan: 2011–2016 nationwide surveys

ObjectiveLow birth weight (LBW) is associated with adverse health outcomes. Incidence of LBW in Taiwan grew from 5% in 1997 to 8.4% in 2016. This study aims to identify the role of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in LBW rate changes during 2011–2016.Materials and methodsWe analyzed 66 135 postpartum women from 6 cross-sectional national surveys. Data were collected through telephone interviews with randomly selected mothers. Logistic regression was applied to assess contribution of maternal characteristics to LBW time changes.ResultsLBW increased from 5.3% to 7.0% during 2011–2016 (crude odds ratio (OR) = 1.04/year, p-value for trend = 0.001). Inadequate GWG increased from 27.9% to 41.5% (p-value for trend <0.001). Along with the increase in overweight (9.7%–11.1%) and obese (4.8%–7.4%), prevalence of underweight fluctuated between 16.0% and 17.8%. LBW increased in underweight group from 6.3% to 9.5% (crude OR = 1.09/year, p-value for trend<0.001). Adjustment for GWG attenuated odds ratio per year in total sample (adjusted OR = 1.03, p-value for trend = 0.04) and in underweight (adjusted OR = 1.08, p-value for trend = 0.002).ConclusionsIncreasing percentage of women with inadequate GWG could contribute to LBW increase in Taiwan during 2011–2016, especially for the underweight. Prenatal advice on GWG should be individualized according to pre-pregnancy BMI.     

The relationship between antenatal body attitudes,pre-pregnancy body mass index,and gestational weight gain

Objectivesan estimated 50% of women experience excessive gestational weight gain (GWG). Maternal body attitudes are associated with GWG, however this relationship is complex and may differ based on pre-pregnancy body mass index (BMI) or gestational age. The aim of this study was to explore the moderating role of maternal pre-pregnancy BMI on the relationship between body attitudes in early-to-mid and late pregnancy and GWG.Design/Participantspregnant women less than 18 weeks gestation were recruited for a postal questionnaire study via Australian pregnancy online forums, pregnancy and parenting magazines, and antenatal clinics. In early-mid pregnancy (Time 1; mean (M) = 16.81 weeks gestation, standard deviation (SD) = 1.18), participants reported demographics, pre-pregnancy weight, height, and body attitudes (salience of weight and shape, attractiveness, strength and fitness and feeling fat). In late pregnancy, body attitudes (Time 2; M = 32.65 weeks gestation, SD = 0.91) and weight (Time 3; M = 37.15 weeks gestation, SD = 1.55) were reported. Pre-pregnancy BMI and total GWG were calculated. Moderation analyses were conducted.Findingsin early-mid pregnancy, pre-pregnancy BMI moderated the relationship between feeling fat and GWG. Pre-pregnancy BMI did not moderate the relationship between body attitudes and GWG for salience of weight and shape, attractiveness or strength and fitness in early-mid pregnancy. In late pregnancy, pre-pregnancy BMI moderated the relationship between all four body attitude facets (salience of weight and shape, attractiveness, feeling fat and strength and fitness) and GWG.Conclusion/Implications for practicethe relationship between body attitudes and GWG was moderated by pre-pregnancy BMI, particularly in late pregnancy. It is recommended that antenatal health care providers monitor women's body attitudes throughout pregnancy to aid in the management of healthy GWG and promote positive maternal and infant health outcomes. This is particularly important for women entering pregnancy with an underweight/normal weight BMI.     

Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China

Objective

To look for associations between pregnancy outcomes and prepregnancy body mass index and gestational weight gain among Han women from Shenyang province, China.

Method

A total of 2586 women were distributed across 4 prepregnancy categories according to the Chinese classification of body mass index, and to 4 end-of-pregnancy categories according to median weekly gestational weight gain.

Results

The risks for gestational hypertension, pre-eclampsia, gestational diabetes, and preterm premature rupture of membranes were higher for those who were overweight or obese before becoming pregnant (P < 0.05). Moreover, a gestational weight gain of 0.50 kg per week or greater was associated with a higher risk for gestational hypertension, preterm premature rupture of membranes, and fetal macrosomia (P < 0.05). Women in the highest quartile for weight gain (≥ 0.59 kg per week) were at higher risk for pre-eclampsia (P < 0.05).

Conclusion

A high prepregnancy body mass index and excessive gestational weight gain were associated with increased risks for adverse pregnancy outcomes.     

Reference charts for weight gain and body mass index during pregnancy obtained from a healthy cohort

Objective. To create reference charts for weight gain and body mass index (BMI) in pregnancy derived from longitudinal data obtained in a representative sample of the Argentinean population.

Methods. A prospective cohort of 1439 healthy pregnant women was selected from antenatal clinics in seven different urban regions in Argentina. Serial anthropometric measurements were made at weeks 12, 16, 20, 24, 28, 32, 36 and in the last pre-natal control. Centile curves of body weight and BMI by gestational age were developed using the LMS method.

Results. Mean weight gain at 38 weeks of gestation was 11.9 ± 4.4 kg. There were no differences in total weight gain between women who enter pregnancy with low, normal or overweight; only those women with a pre-pregnancy BMI in the range of obesity showed a significantly lower weight gain (10.2 ± 4.8 kg). At 12 weeks of pregnancy, BMI values of the 10th, 50th and 90th centiles were 19.3, 22.8 and 29.0, and at 38 weeks these values were 23.3, 27.4 and 33.8, respectively.

Conclusion. This BMI for gestational age chart, based on women who delivered normal birth weight infants and processed with modern statistical methods, represents an improvement in pre-natal care monitoring.     

Gestational weight gain within recommended ranges in consecutive pregnancies: A retrospective cohort study

Objective

to examine whether, among parous women, adherence to gestational weight gain (GWG) recommendations in the most recent previous pregnancy is associated with adherence to GWG recommendations in the current pregnancy.

Design

retrospective cohort study.

Setting

review of labour and delivery records from a Massachusetts tertiary-care centre.

Participants

1,325 women who delivered two consecutive singletons from April 2006 to March 2010.

Measurements

pre-pregnancy weight status and adherence to GWG recommendations were categorised using 1990 Institute of Medicine (IOM) guidelines. Analyses were stratified by weight status before the second pregnancy.

Findings

56% and 46% of women gained more than 1990 IOM recommendations during the first and second of consecutive pregnancies; 57% gained within the same adherence category in both pregnancies. Excessive GWG during the first pregnancy was strongly associated with excessive gain during the second pregnancy (adjusted odds ratio [AOR]=5.4 [95% CI: 1.7–16.4] for underweight, 3.7 [95% CI: 2.4–5.5] for normal weight, 3.0 [95% CI: 1.2–7.6] for overweight, and 5.3 [95% CI: 2.4–11.7] for obese women). Inadequate gain in the first of consecutive pregnancies was strongly associated with subsequent inadequate GWG for underweight women (AOR=13.7; 95% CI: 3.9–48.0), normal weight women (AOR=2.9; 95% CI: 1.7–5.1), and obese women (AOR=3.6; 95% CI: 1.4–9.3). Results were similar in sensitivity analyses using IOM 2009 guidelines.

Key conclusions

adherence to GWG recommendations in consecutive pregnancies is highly concordant.

Implications for practice

consideration of GWG during previous pregnancies may facilitate discussions about GWG during prenatal care.     

Gestational weight gain in adolescents: a comparison to the new Institute of Medicine recommendations

Study Objective

To examine the gestational weight gain distributions of healthy adolescents with optimal birth outcomes and compare them to the current 2009 Institute of Medicine (IOM) recommendations.

Design

Secondary data analysis to conduct a population-based, cross-sectional study.

Setting

The Central and Finger Lakes regions of New York state (Perinatal Database System).

Participants

6995 adolescents with healthy singleton pregnancies (1996 to 2002).

Main Outcome Measures

Percentiles of the gestational weight gain distributions were compared within body mass index (BMI) groups categorized using 2 different classification schemes: adolescent BMI percentiles and adult BMI cut-points. We compared these distributions overall and within racial and age groups.

Results

The gestational weight gain distribution does not differ considerably when BMI is classified using adolescent or adult cutoffs. Adolescents have good birth outcomes across a wider gestational weight gain range than recommended by the Institute of Medicine regardless of how pre-pregnancy weight status is categorized. For example, overweight adolescents by adult cutoffs have a range of gestational weight gain from 5.0 kg to 30.0 kg, and overweight adolescents by percentile cutoffs have a range from 5.4 kg to 29.5 kg, whereas the IOM range is 7.5-11.5 kg. Black and young adolescents have a similar distribution to their white and older counterparts.

Conclusion

Practitioners can safely use the new IOM gestational weight gain ranges to monitor weight gain in pregnant adolescent patients using adult BMI classifications. Future research should examine the range of gestational weight gain in adolescents considering a broader scope of birth and maternal outcomes.     

Gestational weight gain and the risk of infant mortality amongst women with normal prepregnancy BMI: the Friedmann-Balayla model

Objective: The study of the association between gestational weight gain (GWG) and infant mortality is riddled with methodological concerns, particularly with limitations in accounting for gestational age-specific weight gain. In our study, we developed a new model, which accounts for gestational age, to determine whether insufficient or excessive GWG is associated with an increased risk of infant death amongst women with normal prepregnancy BMI (18.5–24.9?kg/m²).

Methods: We developed and implemented the Friedmann-Balayla model to mitigate gestational age-related biases in our assessment, and conducted a population-based cohort study using the CDC’s 2013 Period-Linked Birth-Infant Death data. The impact of GWG according to the 2009 IOM guidelines on the risk of infant mortality was estimated using logistic regression analysis, adjusting for relevant confounders.

Results: Our cohort consisted of 1,517,525 singleton deliveries and 6138 infant deaths. Overall, relative to women achieving adequate GWG, neither women gaining insufficient nor excessive weight had greater odds of infant death during the first year of life (OR [95%CI]): 1.06 [0.97–1.17] (p?=?0.174), and 0.98 [0.91–1.04] (p?=?0.523), respectively. This relationship did not change when restricting our analysis to term or preterm deliveries or when conducting sensitivity analyses accounting for maternal morbidities (p?>?0.05).

Conclusion: Using this novel analytic approach, there does not appear to be an increased risk of infant mortality if GWG falls outside of the IOM guidelines in women with normal prepregnancy BMI. Future studies should apply this methodology to other BMI categories.