Cedergren M
Division of Obstetrics and Gynecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Int J Gynaecol Obstet. 2006 Jun;93(3):269-74. doi: 10.1016/j.ijgo.2006.03.002. Epub 2006 Apr 12.
The objective of this study was to estimate the effects of low and high gestational weight gain, in different maternal Body Mass Index (BMI) classes, on obstetric and neonatal outcomes.
A prospective population-based cohort study of 245,526 singleton term pregnancies. Women were grouped in five categories of BMI and in three gestational weight gain categories; < 8 kg (low weight gain), 8-16 kg and >16 kg (high weight gain). Obstetric and neonatal outcomes were evaluated after adjustments for maternal age, parity, smoking, year of birth.
Obese women with low gestational weight gain had a decreased risk for the following outcomes (adjusted odds ratio; 95% confidence interval): preeclampsia (0.52; 0.42-0.62), cesarean section (0.81; 0.73-0.90), instrumental delivery (0.75; 0.63-0.88), and LGA births (0.66; 0.59-0.75). There was a 2-fold increased risk for preeclampsia and LGA infants among average and overweight women with excessive weight gain. High gestational weight gain increased the risk for cesarean delivery in all maternal BMI classes.
The effects of high or low gestational weight gain differ depending on maternal BMI and the outcome variable studied. Obese women may benefit from a low weight gain during pregnancy.
本研究的目的是评估不同孕妇体重指数（BMI）类别中，孕期体重增加过少和过多对产科及新生儿结局的影响。
一项基于人群的前瞻性队列研究，涉及245,526例单胎足月妊娠。女性被分为五类BMI和三类孕期体重增加类别；<8kg（体重增加过少）、8-16kg和>16kg（体重增加过多）。在对产妇年龄、产次、吸烟情况、出生年份进行校正后，评估产科和新生儿结局。
孕期体重增加过少的肥胖女性，以下结局的风险降低（校正比值比；95%置信区间）：子痫前期（0.52；0.42-0.62）、剖宫产（0.81；0.73-0.90）、器械助产（0.75；0.63-0.88）和大于胎龄儿出生（0.66；0.59-0.75）。体重增加过多的平均体重和超重女性，子痫前期和大于胎龄儿的风险增加两倍。孕期体重增加过多会增加所有孕妇BMI类别的剖宫产风险。
孕期体重增加过多或过少的影响因孕妇BMI和所研究的结局变量而异。肥胖女性孕期体重增加过少可能有益。
