Jain Neetu J, Denk Charles E, Kruse Lakota K, Dandolu Vani
New Jersey Department of Health and Senior Services, MCH Epidemiology Program, Trenton, New Jersey 08625-0364, USA.
Am J Perinatol. 2007 May;24(5):291-8. doi: 10.1055/s-2007-981432. Epub 2007 May 18.
Reports by the Institute of Medicine (IOM) recommend that gestational weight gain goals should be modified according to prepregnancy body mass index (BMI), which could result in better maternal and infant outcomes. The authors assessed whether the risk of the pregnancy outcomes such as rate of cesarean section to primiparous and multiparous women, macrosomia, and breastfeeding at 10 weeks postpartum can be modified by following the IOM guidelines for gestational weight gain irrespective of prepregnancy BMI. Staff from the New Jersey Pregnancy Risk Assessment Monitoring System interviewed a sample of women who delivered live births in New Jersey during 2002 through 2005 (n = 7661). In New Jersey, 18% of mothers were obese, 13% were overweight, and 16% were underweight. In logistic regression analyses, after controlling for maternal characteristics, the effect of prepregnancy obesity and weight gain more than 34 lb independently and significantly increased the risk of all four adverse outcomes. For no outcomes was the 25- to 34-pound weight gain category significantly distinguishable from the 16- to 24-pound reference category. These results strongly support the idea that the IOM weight gain recommendation (education during preconception regarding the importance of optimal BMI at the start of pregnancy) will help to achieve better pregnancy outcomes in obese and overweight women.
美国医学研究所（IOM）的报告建议，应根据孕前体重指数（BMI）调整孕期体重增加目标，这可能会带来更好的母婴结局。作者评估了无论孕前BMI如何，遵循IOM的孕期体重增加指南是否可以改变剖宫产率、巨大儿以及产后10周时母乳喂养等妊娠结局的风险。新泽西州妊娠风险评估监测系统的工作人员采访了2002年至2005年期间在新泽西州分娩活产婴儿的女性样本（n = 7661）。在新泽西州，18%的母亲肥胖，13%超重，16%体重过轻。在逻辑回归分析中，在控制了母亲的特征后，孕前肥胖和体重增加超过34磅的影响独立且显著地增加了所有四种不良结局的风险。对于任何结局，体重增加25至34磅的类别与16至24磅的参考类别均无显著差异。这些结果有力地支持了这样一种观点，即IOM的体重增加建议（孕前关于孕期开始时最佳BMI重要性的教育）将有助于肥胖和超重女性获得更好的妊娠结局。
