Yekta Zahra, Ayatollahi Haleh, Porali Reza, Farzin Azadeh
Community Medicine Department, Faculty of Medicine, Urmia University of Medical Sciences,, Urmia, Iran.
BMC Pregnancy Childbirth. 2006 Apr 20;6:15. doi: 10.1186/1471-2393-6-15.
Nutritional status of women has been considered an important prognostic indicator of pregnancy outcomes. Few studies have evaluated patterns of weight gain and pre-pregnancy body mass index in developing regions where malnutrition and poor weight gain as well as maternal obesity have significant influences on the pregnancy outcome. This study aims to show effect of pregnancy body mass index and the corresponding gestational weight gain on the outcome of pregnancy.
On a prospective cross sectional study, two hundred and seventy women from urban areas of Northwest Iran were recruited for participation during their first eight weeks of pregnancy. Body mass index (BMI) was categorized and gestational weight gain was divided into two groups of normal and abnormal based on recommendations of Institute of Medicine (IOM) published in 1990. Chi square and one way ANOVA were used in the univariate analysis of the association between weight gain and corresponding adverse outcomes including cesarean, preterm labor and low neonatal birth weight. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models, while controlling for the following factors: maternal age, parity, and education.
Both pre-pregnancy BMI < 19 and abnormal weight gain during pregnancy were found to be associated with low neonatal birth weight defined as < 2500 g. Abnormal weight gain, during pregnancy was not related to an increased risk of preterm labor or cesarean delivery but it was highly associated with low birth weight (LBW)(P < 0.05).
Low pre-pregnancy BMI is an established risk factor for LBW. Abnormal gestational weight gain may further complicate the pregnancy as an additional risk factor for neonatal LBW. All women, regardless of their pre-pregnancy BMI may be at risk for abnormal weight gain and hence low birth weight. Pre-pregnancy and gestation nutritional assessments remain significant part of all prenatal visits.
女性的营养状况一直被视为妊娠结局的重要预后指标。在营养不良、体重增加不佳以及孕产妇肥胖对妊娠结局有重大影响的发展中地区，很少有研究评估体重增加模式和孕前体重指数。本研究旨在显示妊娠体重指数及相应的孕期体重增加对妊娠结局的影响。
在一项前瞻性横断面研究中，招募了来自伊朗西北部城市地区的270名女性，她们在怀孕的前八周参与研究。根据1990年医学研究所（IOM）发布的建议，将体重指数（BMI）进行分类，并将孕期体重增加分为正常和异常两组。在对体重增加与包括剖宫产、早产和低出生体重在内的相应不良结局之间的关联进行单因素分析时，使用了卡方检验和单因素方差分析。通过多元逻辑回归模型确定不良结局的调整比值比，同时控制以下因素：产妇年龄、产次和教育程度。
孕前BMI<19以及孕期体重增加异常均与定义为<2500g的低出生体重相关。孕期体重增加异常与早产或剖宫产风险增加无关，但与低出生体重（LBW）高度相关（P<0.05）。
孕前BMI低是低出生体重的既定危险因素。异常的孕期体重增加可能会使妊娠进一步复杂化，成为新生儿低出生体重的另一个危险因素。所有女性，无论其孕前BMI如何，都可能有体重增加异常的风险，进而有低出生体重的风险。孕前和孕期营养评估仍然是所有产前检查的重要组成部分。
