Radhakrishnan Usha, Kolar Geeta, Nirmalan Praveen K
Department of Fetal Medicine and Ultrasonography, Fernandez Hospital, Hyderabad, India.
J Obstet Gynaecol Res. 2014 Jan;40(1):25-31. doi: 10.1111/jog.12115. Epub 2013 Jul 22.
The aim of this study was to determine maternal and neonatal outcomes of less than recommended or excess gestational weight gain (GWG) based on the recommended Institute of Medicine (IOM) guidelines.
Using a cross-sectional study design, GWG was assessed for 1462 pregnant women presenting to a tertiary care perinatal institute in India. Body mass index at baseline, co-existing morbidities, fetal growth, details of delivery, and maternal and fetal outcomes were determined and documented. Appropriate GWG for each woman was determined based on the revised IOM guidelines. Outcome measures included the proportion of pregnant women compliant with IOM guidelines for GWG and associations of less than recommended or excess GWG with maternal and neonatal outcomes.
A total of 547 (37.41%, 95% confidence interval [CI]: 34.96-39.92) pregnant women gained less than recommended and 313 (21.41%, 95%CI: 19.36-23.57) pregnant women gained more than the recommended weight. Preterm deliveries were associated with less than optimal weight gain (adjusted odds ratio 3.58, 95%CI: 1.75-7.32) after adjusting for gestational age at delivery. GWG was not associated with neonatal outcomes in this population.
The lack of associations with perinatal outcomes indicates that the IOM guidelines may not be the appropriate standard for monitoring GWG in this population.
本研究旨在根据美国医学研究所(IOM)推荐的指南,确定孕期体重增加未达推荐标准或超过推荐标准时的母婴结局。
采用横断面研究设计,对印度一家三级围产期护理机构的1462名孕妇的孕期体重增加情况进行评估。测定并记录孕妇的基线体重指数、并存疾病、胎儿生长情况、分娩细节以及母婴结局。根据修订后的IOM指南确定每位孕妇的适宜孕期体重增加量。结局指标包括符合IOM孕期体重增加指南的孕妇比例,以及未达推荐标准或超过推荐标准的孕期体重增加与母婴结局之间的关联。
共有547名(37.41%,95%置信区间[CI]:34.96 - 39.92)孕妇孕期体重增加未达推荐标准,313名(21.41%,95%CI:19.36 - 23.57)孕妇孕期体重增加超过推荐标准。在对分娩时的孕周进行校正后,早产与体重增加未达最佳标准相关(校正比值比3.58,95%CI:1.75 - 7.32)。在该人群中,孕期体重增加与新生儿结局无关。
孕期体重增加与围产期结局缺乏关联,这表明IOM指南可能并非该人群监测孕期体重增加的合适标准。