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[体重指数和孕期体重增加作为预测并发症及妊娠结局的因素]

[Body mass index and gestational weight gain as factors predicting complications and pregnancy outcome].

作者信息

Gonçalves Carla Vitola, Mendoza-Sassi Raul Andres, Cesar Juraci Almeida, de Castro Natália Bolbadilha, Bortolomedi Ana Paula

机构信息

Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil.

出版信息

Rev Bras Ginecol Obstet. 2012 Jul;34(7):304-9. doi: 10.1590/s0100-72032012000700003.

Abstract

PURPOSE

To evaluate the impact of body mass index (BMI) at the beginning of pregnancy and weight gain on pregnancy outcome so that this measure can be implemented and valued by prenatal care health services.

METHOD

Cross-sectional population-based study of all births in the only two hospitals in Rio Grande city (Brazil), in 2007. Among the 2,557 mothers interviewed, it was possible to calculate BMI in only 1,117. The Stata 11 software was used for data analysis. Logist regression was applied to the outomes involving diabetes mellitus, premature labor and cesarean section. Regarding birth weight, data were adjusted by multinomial logistic regression using as base category the group of 2,500 to 4,000 g. The level of significance was set at p-value <0.05 in a two-tailed test.

RESULTS

There was no increased risk of hypertension or diabetes in patients in the different groups of BMI and weight gain. The risk of preterm delivery was evident in the group with a weight gain ≤ 8 kg (p<0.05). Regarding the route of delivery, it was observed that the higher the BMI in early pregnancy (p=0.001) and the greater the weight gain during pregnancy (p=0.004), the greater the risk of surgical delivery, which reached 11% in the group of obese mothers (p=0.004) and 12% in the group with a weight gain ≥ 17 kg (p=0.001). The weight of the newborns was influenced by BMI and weight gain, and the higher the BMI in early pregnancy and the gestational weight gain, the greater the risk of macrosomia.

CONCLUSION

The monitoring of BMI and weight gain during pregnancy is a low cost and useful procedure for the establishment of nutritional interventions aimed at reducing maternal and fetal risks.

摘要

目的

评估妊娠初期体重指数(BMI)及体重增加对妊娠结局的影响,以便这项措施能被产前保健服务机构采用并重视。

方法

2007年对巴西里奥格兰德市仅有的两家医院所有分娩情况进行基于人群的横断面研究。在接受访谈的2557名母亲中,仅1117名可计算BMI。采用Stata 11软件进行数据分析。对涉及糖尿病、早产和剖宫产的结局应用逻辑回归分析。关于出生体重,以2500至4000克组作为基础类别,通过多项逻辑回归对数据进行校正。双侧检验的显著性水平设定为p值<0.05。

结果

不同BMI和体重增加组的患者患高血压或糖尿病的风险未增加。体重增加≤8千克组早产风险明显(p<0.05)。关于分娩方式,观察到妊娠初期BMI越高(p = 0.001)以及孕期体重增加越多(p = 0.004),手术分娩风险越大,肥胖母亲组手术分娩风险达11%(p = 0.004),体重增加≥17千克组手术分娩风险达12%(p = 0.001)。新生儿体重受BMI和体重增加影响,妊娠初期BMI和孕期体重增加越高,巨大儿风险越大。

结论

孕期监测BMI和体重增加是一种低成本且有用的程序,有助于制定旨在降低母婴风险的营养干预措施。

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