开发一种工具，用于获取超重和肥胖孕妇的体脂厚度测量值，并评估观察者间的变异性。
Developing a tool for obtaining maternal skinfold thickness measurements and assessing inter-observer variability among pregnant women who are overweight and obese.
机构信息
Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, the University of Adelaide, Robinson Institute, Discipline of Obstetrics & Gynaecology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
出版信息
BMC Pregnancy Childbirth. 2013 Feb 19;13:42. doi: 10.1186/1471-2393-13-42.
BACKGROUND
It is estimated that between 34% and 50% of Australian women entering pregnancy are overweight and obese, which is associated with an increased risk in complications for both the woman and her infant. Current tools used in clinical and research practice for measuring body composition include body mass index (BMI), waist circumference and bioimpedance analysis. Not all of these measures are applicable for use during pregnancy due to a lack of differentiation between maternal and fetal contributions. While skinfold thickness measurement (SFTM) is increasingly being used in pregnancy, there is limited data and a lack of a standard tool for its use in overweight and obese pregnant women.
METHODS
We developed a standard tool for evaluating SFTM among women with a BMI≥25 kg/m2. Forty-nine women were measured as part of a prospective cohort study nested within a multicentre randomised controlled trial (The LIMIT Randomised Controlled Trial). Two blinded observers each performed 2 skinfold measurements on the biceps, triceps and subscapular of each woman. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to analyse SFTM, body fat percentage (BF%) and inter-observer variability.
RESULTS
The ICC for inter-observer variability in measurements were considered moderate for biceps SFTM (ICC=0.56) and triceps SFTM (ICC=0.51); good for subscapular SFTM (ICC=0.71) and BF% (ICC=0.74); and excellent for arm circumference (ICC=0.97). The standard error of measurements ranged from 0.53 cm for arm circumference to 3.58 mm for the subscapular SFTM.
CONCLUSION
Our findings indicate that arm circumference and biceps, triceps and subscapular SFTM can be reliably obtained from overweight and obese pregnant women to calculate BF%, using multiple observers, and can be used in a research setting.
TRIAL REGISTRATION
Australian and New Zealand Clinical Trials Registry ACTRN12607000161426.
背景
据估计，有 34%至 50%的澳大利亚孕妇超重或肥胖，这会增加孕妇及其婴儿并发症的风险。目前，临床和研究实践中用于测量身体成分的工具包括身体质量指数（BMI）、腰围和生物阻抗分析。由于无法区分母体和胎儿的贡献，并非所有这些措施都适用于怀孕期间使用。虽然皮褶厚度测量（SFTM）在怀孕期间越来越多地被使用，但对于超重和肥胖孕妇来说，关于其使用的数据有限，并且缺乏标准工具。
方法
我们为 BMI≥25kg/m2 的女性开发了一种评估 SFTM 的标准工具。49 名女性作为一项嵌套在多中心随机对照试验（LIMIT 随机对照试验）中的前瞻性队列研究的一部分进行了测量。两名盲法观察者分别对每位女性的二头肌、三头肌和肩胛下进行了 2 次皮褶测量。使用组内相关系数（ICC）和测量标准误差（SEM）分析 SFTM、体脂肪百分比（BF%）和观察者间变异性。
结果
在测量的观察者间变异性方面，二头肌 SFTM 的 ICC 为中度（ICC=0.56），三头肌 SFTM 的 ICC 为中度（ICC=0.51）；肩胛下 SFTM 的 ICC 为良好（ICC=0.71），BF%的 ICC 为良好（ICC=0.74）；臂围的 ICC 为极好（ICC=0.97）。测量的标准误差范围从臂围的 0.53cm 到肩胛下 SFTM 的 3.58mm。
结论
我们的研究结果表明，臂围以及二头肌、三头肌和肩胛下 SFTM 可以通过多位观察者从超重和肥胖孕妇中可靠地获得，以计算 BF%，并且可以在研究环境中使用。
试验注册
澳大利亚和新西兰临床试验注册 ACTRN12607000161426。
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