Siega-Riz Anna Maria, Viswanathan Meera, Moos Merry-K, Deierlein Andrea, Mumford Sunni, Knaack Julie, Thieda Patricia, Lux Linda J, Lohr Kathleen N
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
Am J Obstet Gynecol. 2009 Oct;201(4):339.e1-14. doi: 10.1016/j.ajog.2009.07.002.
This systematic review focuses on outcomes of gestational weight gain, specifically birthweight, fetal growth, and postpartum weight retention, for singleton pregnancies with respect to the 1990 Institute of Medicine weight gain recommendations. A total of 35 studies met the inclusion criteria and were reviewed. There was strong evidence to support associations between excessive gestational weight gain and increased birthweight and fetal growth (large for gestational age) as well as inadequate gestational weight gain and decreased birthweight and fetal growth (small for gestational age). There was moderate evidence to support the association between excessive gestational weight gain and postpartum weight retention. Clear clinical recommendations based on this review are challenging because of several limitations in the literature. Improvements in future research include the use of consistent definitions of gestational weight gain and outcomes of interest, assessment of confounders, and better collection of weight and weight gain data.
本系统评价聚焦于单胎妊娠的孕期体重增加结局，特别是出生体重、胎儿生长及产后体重滞留情况，参照1990年美国医学研究所的体重增加建议。共有35项研究符合纳入标准并接受了审查。有强有力的证据支持孕期体重过度增加与出生体重增加、胎儿生长（大于胎龄）之间的关联，以及孕期体重增加不足与出生体重降低、胎儿生长（小于胎龄）之间的关联。有中等证据支持孕期体重过度增加与产后体重滞留之间的关联。由于文献存在若干局限性，基于本评价得出明确的临床建议具有挑战性。未来研究的改进方向包括采用一致的孕期体重增加及相关结局定义、评估混杂因素，以及更好地收集体重和体重增加数据。
