Mewitz M, Voigt M, Schild R L, Straube W, Guthmann F, Straube S
Department of Obstetrics and Perinatal Medicine, Diakoniekrankenhaus Friederikenstift, Hannover, Germany.
Z Geburtshilfe Neonatol. 2012 Feb;216(1):22-6. doi: 10.1055/s-0031-1298028. Epub 2012 Feb 13.
Weight gain during pregnancy is an important parameter that is related to a number of perinatal outcomes. We aimed to analyse the relationships between weight gain during pregnancy, duration of pregnancy, and the somatic classification of the neonates as small, appropriate, or large for gestational age (SGA, AGA, LGA).
Data were from the German perinatal survey of 1995-2000 (more than 2.2 million singleton pregnancies). We classified all neonates with a birth weight below the 10th population percentile as SGA, those with a birth weight above the 90th percentile as LGA, and all others were AGA. Duration of pregnancy (categorised as ≤ 36, 37-41, or ≥ 42 completed weeks of gestation) and the percentages of SGA, AGA, and LGA neonates were analysed according to maternal weight gain in 1-kg-steps.
Small weight gain was associated with higher rates of preterm birth, i.e. birth after ≤ 36 completed weeks of gestation (preterm birth rates >10% for women who gained <9 kg). SGA rates were greater for low weight gain values and LGA rates were greater for high weight gain values. For weight gains <12 kg, SGA rates were always >10%. For weight gains >14 kg LGA rates were always >10% reaching LGA rates >25% for weight gains in the range 33-35 kg.
Weight gain during pregnancy may be of use as a predictor of perinatal outcomes such as the somatic classification of neonates. Further analyses taking account of factors influencing the weight gain during pregnancy are warranted.
孕期体重增加是一个重要参数,与许多围产期结局相关。我们旨在分析孕期体重增加、孕期时长与新生儿按小于胎龄儿(SGA)、适于胎龄儿(AGA)或大于胎龄儿(LGA)进行的体格分类之间的关系。
数据来自1995 - 2000年德国围产期调查(超过220万例单胎妊娠)。我们将所有出生体重低于第10百分位数的新生儿分类为SGA,出生体重高于第90百分位数的新生儿分类为LGA,其他所有新生儿为AGA。根据母亲以1千克为步长的体重增加情况,分析孕期时长(分类为≤36、37 - 41或≥42孕周)以及SGA、AGA和LGA新生儿的百分比。
体重增加少与早产发生率较高相关,即妊娠≤36孕周后出生(体重增加<9千克的女性早产率>10%)。低体重增加值时SGA发生率较高,高体重增加值时LGA发生率较高。对于体重增加<12千克,SGA发生率总是>10%。对于体重增加>14千克,LGA发生率总是>10%,体重增加在33 - 35千克范围内时LGA发生率>25%。
孕期体重增加可作为围产期结局(如新生儿体格分类)的预测指标。有必要进一步分析考虑影响孕期体重增加的因素。