Magriples Urania, Kershaw Trace S, Rising Sharon Schindler, Westdahl Claire, Ickovics Jeannette R
Yale University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New Haven, Connecticut 06520-8034, USA.
Am J Perinatol. 2009 May;26(5):365-71. doi: 10.1055/s-0028-1110088. Epub 2008 Dec 11.
We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almost half the patients were overweight or obese. An average of 32.3 +/- 23.6 pounds was gained in pregnancy with only 25.3% gaining the recommended weight and over half overgaining. Weight gain had a significant relationship to birth weight. Multivariate analysis showed that prepregnancy BMI but not weight gain was a significant predictor of cesarean delivery (odds ratio [OR] 1.91, confidence interval [CI] 1.24 to 2.69, P < 0.0001). When large-for-gestational-age infants were removed from the analysis, there was still a significant effect of BMI on cesarean delivery (OR 1.76, CI 1.17 to 2.66, P = 0.007) but not of weight gain (OR 1.45, CI 0.94 to 2.17, P = 0.093). Prepregnancy BMI is a more significant predictor of cesarean delivery than pregnancy weight gain in young women.
我们调查了年龄在14至25岁的孕妇的体重指数（BMI）和体重增加情况，并评估了BMI和体重增加与分娩结局之间的关系。我们对在两家大学附属医院诊所接受产前护理的841名参与随机对照试验的女性进行了二次分析。几乎一半的患者超重或肥胖。孕期平均体重增加32.3±23.6磅，只有25.3%的孕妇增加了推荐体重，超过一半的孕妇体重增加过多。体重增加与出生体重有显著关系。多变量分析显示，孕前BMI而非体重增加是剖宫产的显著预测因素（优势比[OR]1.91，置信区间[CI]1.24至2.69，P<0.0001）。当将大于胎龄儿从分析中排除时，BMI对剖宫产仍有显著影响（OR 1.76，CI 1.17至2.66，P = 0.007），但体重增加无显著影响（OR 1.45，CI 0.94至2.17，P = 0.093）。在年轻女性中，孕前BMI比孕期体重增加是剖宫产更显著的预测因素。
