Departments of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, the University of Pittsburgh, Pittsburgh, Pennsylvania, the University of Cincinnati, Cincinnati, Ohio, the University of Alabama at Birmingham, Birmingham, Alabama, the University of Utah, Salt Lake City, Utah, Columbia University, New York, New York, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio, Northwestern University, Chicago, Illinois, the University of Texas Health Science Center at Houston, Houston, Texas, The Ohio State University, Columbus, Ohio, Drexel University, Philadelphia, Pennsylvania, Wake Forest University Health Sciences, Winston-Salem, North Carolina, Oregon Health & Science University, Portland, Oregon, University of Texas Medical Branch, Galveston, Texas, and Wayne State University, Detroit, Michigan; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Obstet Gynecol. 2013 May;121(5):969-975. doi: 10.1097/AOG.0b013e31828aea03.
To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines.
This study is a secondary analysis of a preeclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines.
Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90 centile but a decreased risk of weight below the 10 centile. There were no consistent associations with insufficient weight gain and adverse outcomes.
Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.
根据 2009 年美国医学研究所（IOM）的妊娠体重增加指南评估妊娠结局。
本研究是对一项针对单胎初产妇子痫前期预防试验的二次分析。根据孕前体重指数（BMI），将低于或高于 IOM 指南的总增重进行分层，计算比值比和 95%置信区间（调整了母亲年龄、种族、吸烟和治疗组）。参考组是体重增加在指南范围内。
在 8293 例妊娠中，9.5%的孕妇体重增加低于指南，17.5%的孕妇体重增加在指南内，73%的孕妇体重增加超过指南。体重增加过多时，所有 BMI 类别都增加了患高血压疾病的风险；正常体重和超重的女性也增加了剖宫产和新生儿出生体重在第 90 百分位或以上的风险，但体重低于第 10 百分位的风险降低。体重不足与不良结局之间没有一致的关联。
体重增加过多很常见，并与高血压疾病、剖宫产和巨大儿的风险增加相关。
