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美国与墨西哥边境某州西班牙裔女性孕期体重增加过多或不足的风险因素。

Risk factors for excessive or inadequate gestational weight gain among Hispanic women in a U.S.-Mexico border state.

作者信息

Walker Lorraine O, Hoke Mary M, Brown Adama

机构信息

School of Nursing, University of Texas at Austin, 1700 Red River Street, Austin, TX,

出版信息

J Obstet Gynecol Neonatal Nurs. 2009 Jul-Aug;38(4):418-29. doi: 10.1111/j.1552-6909.2009.01036.x.

Abstract

OBJECTIVE

To identify risk factors for excessive or inadequate gestational weight gain and associated morbidities among Hispanic women in a U.S.-Mexico border state.

DESIGN

Case-control design.

SETTING

New Mexico.

PARTICIPANTS

Hispanic women responding to the New Mexico Pregnancy Risk Assessment Monitoring System 2000 to 2003; 1,597 women in final excessive versus adequate gestational weight gain analyses and 1,351 in final inadequate versus adequate gestational weight gain analyses.

METHODS

Information from birth certificates and Pregnancy Risk Assessment Monitoring System questionnaires were use in logistic regression analyses to identify risk factors and associated events.

RESULTS

Prevalence of excessive gestational weight gain was 35.7%, while inadequate gestational weight gain was 30.4%. Among factors associated with increased risk of excessive gestational weight gain were overweight (odds ratio [OR]=2.87, 95% confidence interval [CI]=2.11, 3.90) or obese status (OR=1.82, 95% CI=1.38, 2.39), whereas residing in a U.S.-Mexico border county reduced such risk (OR=0.75, 95% CI=0.59, 0.97). Among risk factors for inadequate gestational weight gain were gestational diabetes (OR=1.58, 95% CI=1.05, 2.37) and inadequate prenatal care (OR=2.17, 95% CI=1.56, 3.02). After adjusting for confounders, inadequate gestational weight gain increased risk of low birth weight (OR=l.92, 95% CI=1.11, 3.29), while excessive gestational weight gain reduced this risk (OR=0.29, 95% CI=0.12, 0.68) but increased risk of macrosomia (OR=2.07, 95% CI=1.32, 3.25).

CONCLUSION

Prepregnant overweight and obese status were among factors associated with excessive gestational weight gain among Hispanic women, whereas inadequate prenatal care was among factors associated with increased risk of inadequate gestational weight gain.

摘要

目的

确定美国与墨西哥边境一州的西班牙裔女性孕期体重增加过多或不足的风险因素及相关发病情况。

设计

病例对照研究设计。

地点

新墨西哥州。

参与者

对2000年至2003年新墨西哥州妊娠风险评估监测系统做出回应的西班牙裔女性;最终纳入孕期体重增加过多与增加适当分析的有1597名女性,纳入孕期体重增加不足与增加适当分析的有1351名女性。

方法

出生证明和妊娠风险评估监测系统问卷中的信息用于逻辑回归分析,以确定风险因素和相关事件。

结果

孕期体重增加过多的患病率为35.7%,而孕期体重增加不足的患病率为30.4%。与孕期体重增加过多风险增加相关的因素包括超重(比值比[OR]=2.87,95%置信区间[CI]=2.11,3.90)或肥胖状态(OR=1.82,95%CI=1.38,2.39),而居住在美国与墨西哥边境县会降低此类风险(OR=0.75,95%CI=0.59,0.97)。与孕期体重增加不足相关的风险因素包括妊娠期糖尿病(OR=1.58,95%CI=1.05,2.37)和产前护理不足(OR=2.17,95%CI=1.56,3.02)。在对混杂因素进行调整后,孕期体重增加不足会增加低出生体重的风险(OR=1.92,95%CI=1.11,3.29),而孕期体重增加过多会降低此风险(OR=0.29,95%CI=0.12,0.68),但会增加巨大儿的风险(OR=2.07,95%CI=1.32,3.25)。

结论

孕前超重和肥胖状态是西班牙裔女性孕期体重增加过多相关的因素,而产前护理不足是孕期体重增加不足风险增加相关的因素。

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