Bish Connie L, Chu Susan Y, Shapiro-Mendoza Carrie K, Sharma Andrea J, Blanck Heidi Michels
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Matern Child Health J. 2009 Mar;13(2):286-92. doi: 10.1007/s10995-008-0349-x. Epub 2008 May 1.
Current pregnancy weight gain recommendations are for women to gain between 15 and 40 pounds; weight loss or weight maintenance is not recommended. However, for many women, overweight and obesity are chronic conditions, and commitment to weight loss or maintenance could override advice to gain weight during pregnancy. Our objective was to determine the prevalence of trying to lose or maintain weight among U.S. women during pregnancy.
The Behavioral Risk Factor Surveillance System is a state-based, random-digit-dialed telephone survey of noninstitutionalized, U.S. civilians aged > or =18 years. We identified women aged 18-44 years who reported being pregnant during 2003 (n = 2,464), assessed the prevalence of trying to lose or maintain weight and assessed independent associations with selected demographic, clinical, and behavioral factors using multinomial logistic regression.
Among women who reported being pregnant, 7.5% (confidence interval [CI] = 5.7-9.8%) and 34.3% (CI = 31.0-37.7%) were trying to lose or maintain weight, respectively. Among women who reported trying to lose or maintain weight, exercise was a more prevalent weight control strategy than dietary change. After adjustment, women who drank alcohol during the past 30 days (Odds ratio [OR] = 8.86, CI: 4.51-17.42) or women who received advice in the past year to lose weight (OR = 9.10, CI: 3.20-25.87) were more likely to report trying to lose weight; women advised to maintain (OR = 0.20, CI: 0.07-0.60) or gain (OR = 0.04, CI: 0.01-0.23) weight were less likely to report trying to lose weight.
Despite guidelines to gain weight during pregnancy, about 8% and 34% of U.S. pregnant women reported trying to lose or maintain weight, respectively. Providers may encounter an increasing number of pregnant women whose weight control intentions conflict with current guidelines for pregnancy weight gain. Further research in this area is warranted.
目前关于孕期体重增加的建议是女性增重15至40磅；不建议减肥或维持体重。然而，对许多女性来说，超重和肥胖是慢性病，坚持减肥或维持体重可能会压倒孕期增重的建议。我们的目的是确定美国孕期女性中试图减肥或维持体重的比例。
行为危险因素监测系统是一项基于州的、通过随机数字拨号对年龄大于或等于18岁的非机构化美国平民进行的电话调查。我们确定了2003年报告怀孕的18至44岁女性（n = 2464），评估试图减肥或维持体重的比例，并使用多项逻辑回归评估与选定的人口统计学、临床和行为因素的独立关联。
在报告怀孕的女性中，分别有7.5%（置信区间[CI]=5.7 - 9.8%）和34.3%（CI = 31.0 - 37.7%）试图减肥或维持体重。在报告试图减肥或维持体重的女性中，运动是比饮食改变更普遍的体重控制策略。调整后，过去30天饮酒的女性（比值比[OR]=8.86，CI：4.51 - 17.42）或过去一年接受过减肥建议的女性（OR = 9.10，CI：3.20 - 25.87）更有可能报告试图减肥；被建议维持（OR = 0.20，CI：0.07 - 0.60）或增重（OR = 0.04，CI：0.01 - 0.23）体重的女性报告试图减肥的可能性较小。
尽管有孕期增重的指导方针，但分别约有8%和34%的美国孕妇报告试图减肥或维持体重。医疗服务提供者可能会遇到越来越多体重控制意图与当前孕期增重指南相冲突的孕妇。该领域有必要进行进一步研究。
