Amorim Amanda R, Linné Yvonne, Kac Gilberto, Lourenço Paulo M
Obesity Unit, Karolinska Institutet, Stockholm, Sweden.
Matern Child Nutr. 2008 Jan;4(1):1-13. doi: 10.1111/j.1740-8709.2007.00093.x.
The usefulness of routine prenatal weight measurements in predicting pregnancy outcomes is still a controversial issue. Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators applied to express maternal weight changes during and after pregnancy. A review of literature was conducted to clarify the definitions and examine the strengths and limitations of methods for measuring gestational weight gain (WG) and postpartum weight changes. The reasons for weak correlations or non-significant associations between gestational WG and maternal and neonatal outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute gestational WG. The choice of an indicator depends on clinical and research purpose, availability and reliability of data and cost. Considering the health implication of gestational WG, it is necessary to take into account the measurements used as initial and final weight, accuracy of gestational age estimation and the inclusion of fetal weight as part of maternal WG. Regardless of the indicators used to compute the weight changes after delivery, attention is drawn to the approach for designating prepregnancy weight, the time frame of postpartum weight measurements and the use of overlapping variables, which results in bias (part-whole correlation). It is necessary to address criticisms on the accuracy of prenatal weight measurements and the way of expressing the maternal weight changes during and after pregnancy in order to have reliable results from research.
常规产前体重测量在预测妊娠结局方面的实用性仍是一个有争议的问题。由于用于表达孕期及产后母体体重变化的指标多种多样，各研究之间的比较以及研究结果的解读变得复杂。我们进行了文献综述，以明确定义并审视测量孕期体重增加（WG）及产后体重变化方法的优缺点。孕期WG与母体及新生儿结局之间相关性较弱或无显著关联，其原因可能是产科记录质量欠佳以及计算孕期WG时选用了错误的指标。指标的选择取决于临床及研究目的、数据的可获取性和可靠性以及成本。考虑到孕期WG对健康的影响，有必要考虑用作初始体重和最终体重的测量方法、孕周估计的准确性以及将胎儿体重纳入母体WG的情况。无论采用何种指标来计算分娩后的体重变化，都要注意指定孕前体重的方法、产后体重测量的时间框架以及重叠变量的使用，这些会导致偏差（部分与整体的相关性）。有必要解决对产前体重测量准确性以及孕期及产后母体体重变化表达方式的批评，以便从研究中获得可靠结果。
