Begum Fatheema, Colman Ian, McCargar Linda J, Bell Rhonda C
Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton AB.
J Obstet Gynaecol Can. 2012 Jul;34(7):637-47. doi: 10.1016/s1701-2163(16)35316-6.
To describe gestational weight gain during pregnancy, adherence to Health Canada 2010 Gestational Weight Gain Guidelines, and the effects of weight gain on postpartum weight retention in women with different pre-pregnancy body mass indices.
Body weight data were collected from women during pregnancy and in the early postpartum period as part of this prospective cohort study; analyses are presented for the first 600 women recruited. Multilinear regression was used to assess associations between pre-pregnancy BMI, total gestational weight gain, and postpartum weight retention. Multinomial regression was used to assess adherence to guidelines for total weight gain and rates of weekly weight gain.
Women who gained above recommendations were more likely to be overweight (OR 5.5; 95% CI 2.7 to 10.9, P < 0.001) or obese (OR 6.5; 95% CI 2.5 to 16.5, P < 0.001) before pregnancy, to have a history of smoking (OR 1.96; 95% CI 1.18 to 3.26, P = 0.01), or to be nulliparous (OR 2.23; 95% CI 0.99 to 5.05, P = 0.054). Women who gained weight above recommendations (P < 0.001) and women with low income (P < 0.01) were more likely to retain higher body weight at three months postpartum. Seventy-one percent of participants exceeded recommended rates of weekly weight gain; average weekly weight gain of these women was 0.65 ± 0.17 kg.
Pre-pregnancy BMI is a significant predictor of excessive weight gain in pregnancy. Higher gestational weight gain predisposes women to higher postpartum weight retention across all BMI categories. Future studies are warranted to design tools and intervention programs to monitor weight gain during pregnancy.
描述孕期体重增加情况、对加拿大卫生部2010年孕期体重增加指南的遵循情况，以及不同孕前体重指数的女性体重增加对产后体重滞留的影响。
作为这项前瞻性队列研究的一部分，收集了女性孕期和产后早期的体重数据；对招募的前600名女性进行了分析。采用多线性回归评估孕前体重指数、孕期总体重增加与产后体重滞留之间的关联。采用多项回归评估总体重增加指南的遵循情况和每周体重增加率。
孕期体重增加超过建议值的女性孕前更有可能超重（比值比5.5；95%置信区间2.7至10.9，P<0.001）或肥胖（比值比6.5；95%置信区间2.5至16.5，P<0.001），有吸烟史（比值比1.96；95%置信区间1.18至3.26，P = 0.01），或为初产妇（比值比2.23；95%置信区间0.99至5.05，P = 0.054）。孕期体重增加超过建议值的女性（P<0.001）和低收入女性（P<0.01）在产后三个月更有可能保持较高体重。71%的参与者每周体重增加超过建议率；这些女性的平均每周体重增加为0.65±0.17千克。
孕前体重指数是孕期体重过度增加的重要预测因素。在所有体重指数类别中，孕期体重增加越高，女性产后体重滞留的可能性越大。有必要开展进一步研究，设计工具和干预项目来监测孕期体重增加情况。
