Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México City, México.
Gynecol Obstet Invest. 2012;73(1):75-81. doi: 10.1159/000329899. Epub 2011 Sep 2.
BACKGROUND/AIMS: To compare the gestational weight gain and adverse perinatal outcomes in urban Mexican women with prepregnancy overweight or obesity, under an early intensive obstetric and nutrition program versus women with prepregnancy normal weight.
A cohort of 546 pregnant women with prepregnancy normal weight (n = 201, NW), overweight (n = 171, OW) or obesity (n = 174, OB), ≤13 weeks of gestation and a singleton pregnancy. OW and OB groups were under early intensive obstetric and nutritional care and NW group was under routine prenatal care. Miscarriage, hypertensive disorders, premature rupture of membranes, preterm birth, stillbirth, gestational diabetes mellitus (GDM) and large- or small-for-gestational-age newborns, were compared between groups.
Weight gain was smaller in OB than in OW or NW (mean ± SD): 6.1 ± 4.4, 9.5 ± 5.1, 10.3 ± 5.4 kg, respectively (p < 0.001). OB women had the highest frequency of GDM (p < 0.001), lack of spontaneous labor (p < 0.001) and preeclampsia (p < 0.001), but no other between-group differences existed.
Early intensive medical-nutrition prenatal care and adequate gestational weight gain may contribute to decreasing most maternal and newborn adverse outcomes associated with prepregnancy overweight or obesity.
背景/目的：比较在早期强化产科和营养计划下，患有超重或肥胖的墨西哥城市妇女与孕前体重正常的妇女的妊娠体重增加和不良围产期结局。
对 546 名孕龄≤13 周且单胎妊娠的孕前体重正常（n=201，NW）、超重（n=171，OW）或肥胖（n=174，OB）的孕妇进行了一项队列研究。OW 和 OB 组接受早期强化产科和营养护理，NW 组接受常规产前护理。比较各组之间的流产、高血压疾病、胎膜早破、早产、死产、妊娠期糖尿病（GDM）和大于胎龄或小于胎龄儿的发生率。
OB 组的体重增加明显少于 OW 组或 NW 组（均值±标准差）：分别为 6.1±4.4、9.5±5.1 和 10.3±5.4kg（p<0.001）。OB 组的 GDM 发生率最高（p<0.001）、缺乏自发性分娩（p<0.001）和子痫前期（p<0.001），但其他组间差异不明显。
早期强化医疗营养产前护理和适当的妊娠体重增加可能有助于降低与超重或肥胖相关的大多数产妇和新生儿不良结局。
