Ochsenbein-Kölble Nicole, Roos Malgorzata, Gasser Theo, Zimmermann Roland
Obstetric Research Unit, Department of Obstetrics, University Hospital, Frauenklinikstr. 10, CH-8091 Zurich, Switzerland.
Eur J Obstet Gynecol Reprod Biol. 2007 Feb;130(2):180-6. doi: 10.1016/j.ejogrb.2006.03.024. Epub 2006 May 12.
To generate reliable new reference ranges for weight gain and increase in body mass index (BMI) during pregnancy from a large population.
In a prospective cross-sectional study at the Obstetric outpatient clinic, Zurich University Hospital, weight gain and BMI, before gestation and at the booking visit, were determined in 4034 pregnant women with accurately dateable singleton pregnancies (Caucasian: N = 3242, Asian (predominantly from Sri Lanka, Thailand and the Philippines): N = 578 and Black: N = 214). Women with known insulin-dependent diabetes mellitus before pregnancy were excluded. Fifth, 50th and 95th centiles were presented for Caucasians and corresponding centile curves for Asians and Blacks. Simple and multiple regression analyses were performed for various risk factors. A significance level of P < 0.05 was used in all tests.
Mean weight gain was 15.5+/-5.9 kg (34.2+/-13.0 lb) at term with values >25.4 kg (56.0 lb) and <5.7 kg (12.6 lb) for the 95th and the 5th centile, respectively. Mean BMI increased slightly and steadily to 28 kgm(-2) at term. Parity and pre-pregnancy BMI were significant determinants in Caucasians. Weight gain and BMI was slightly lower in Asians and Blacks.
BMI centile curves have the advantage in that they consider height during the whole course of pregnancy. It may be an additional helpful tool in controlling weight gain in pregnancy. Further studies are required to determine the prognostic implications of values > or = 95th centile and < or = 5th centile.
从大量人群中得出孕期体重增加及体重指数(BMI)增长的可靠新参考范围。
在苏黎世大学医院产科门诊进行的一项前瞻性横断面研究中,对4034例有准确可确定日期的单胎妊娠孕妇(白人:N = 3242,亚洲人(主要来自斯里兰卡、泰国和菲律宾):N = 578,黑人:N = 214)在妊娠前及初次产检时的体重增加情况和BMI进行了测定。排除妊娠前已知患有胰岛素依赖型糖尿病的妇女。给出了白人的第5、第50和第95百分位数,以及亚洲人和黑人相应的百分位数曲线。对各种风险因素进行了简单和多元回归分析。所有检验的显著性水平为P < 0.05。
足月时平均体重增加为15.5±5.9 kg(34.2±13.0磅),第95和第5百分位数分别>25.4 kg(56.0磅)和<5.7 kg(12.6磅)。足月时平均BMI略有稳步上升至28 kg/m²。产次和妊娠前BMI是白人的显著决定因素。亚洲人和黑人的体重增加和BMI略低。
BMI百分位数曲线的优点在于其在整个孕期过程中考虑了身高因素。它可能是控制孕期体重增加的又一有用工具。需要进一步研究以确定第95百分位数及以上或第5百分位数及以下数值的预后意义。