Wang Wen-peng, Chen Fang-fang, Mi Jie, Teng Yue, Zhao Juan, Wu Ming-hui, Zhang Xue, Zhang Di, Wang Jun-hua, Teng Hong-hong
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Zhonghua Fu Chan Ke Za Zhi. 2013 May;48(5):321-5.
To explore the appropriate weight gain during pregnancy and its relationship with the birthweight of offspring.
A total of 16 460 healthy pregnant women who delivered in Beijing Obstetrics and Gynecology Hospital and Haidian Maternity and Child Health Care Hospital in 2010 were recruited. All are singleton pregnancies. Conditions of babies and mothers were recorded, including maternal age, height, prepregnant weight, pregnant weight, gestational weeks on delivery, delivery mode and newborn birthweight. All the pregnant women were divided into underweight, normal weight and overweight group according to their prepregnant body mass index and the criteria of overweight and obesity for Chinese adults.Birthweight between 2500 g and 4000 g was defined as normal birthweight, and 2900 g to 3499 g was defined as appropriate birthweight.Logistic regression model and receiver operating characteristic (ROC) curve analysis were used to explore the recommended gestational weight gain (GWG).
(1) The average GWG of the 16 460 women was (17.1 ± 4.9) kg, and the average birthweight of the babies was (3406 ± 400) g. Prevalence of low birthweight and macrosomia was 0.92% (152/16 460) and 7.55% (1 242/16 460), respectively.GWG of underweight (n = 3089), normal weight (n = 11 478) and overweight group (n = 1893) was (17.4 ± 4.6) kg, (17.3 ± 4.8) kg and (15.6 ± 5.3) kg, respectively. And GWG was positively related with the birthweight of offspring (P < 0.01).The differences of GWG, neonatal birthweight and macrosomia prevalence among the three groups are statistically significant (P < 0.01). (2) There are 8449 appropriate birthweight babies in the three groups.For their mothers in the underweight, normal weight and overweight group, the recommended range of GWG were 14.0-19.5 kg, 13.5-19.5 kg and 11.0-18.0 kg, respectively.The recommended GWG for all women was 16.0 kg. (3) According to the recommended GWG, low GWG will increase the risk of low birthweight (OR = 1.589, 95% CI: 1.085-2.326) and reduce the risk of macrosomia (OR = 0.500, 95% CI: 0.401-0.624). Excessive GWG will increase the risk of macrosomia (OR = 2.031, 95% CI:1.789-2.306), but will not lower the risk of low birthweight (OR = 1.168, 95% CI:0.774-1.764). (4) For the underweight, normal weight and overweight group, the range of GWG obtained by the receiver operating characteristic (ROC) curve analysis were 16.3-16.7 kg, 15.6-17.8 kg and 14.6-15.1 kg.For all the three groups, the range was 15.6-16.7 kg.The ranges obtained by the ROC curve analysis were all within the recommended range.
The GWG was positively associated with the birthweight of offspring, and the appropriate GWG was around 16.0 kg.
探讨孕期适宜的体重增加及其与子代出生体重的关系。
选取2010年在北京妇产医院和海淀区妇幼保健院分娩的16460例健康孕妇。均为单胎妊娠。记录母婴情况，包括产妇年龄、身高、孕前体重、孕期体重、分娩孕周、分娩方式及新生儿出生体重。根据孕前体重指数及中国成年人超重与肥胖标准，将所有孕妇分为体重过低、正常体重和超重组。出生体重在2500 g至4000 g之间定义为正常出生体重，2900 g至3499 g定义为适宜出生体重。采用逻辑回归模型和受试者工作特征（ROC）曲线分析来探讨推荐的孕期体重增加量（GWG）。
（1）16460名女性的平均GWG为（17.1±4.9）kg，婴儿的平均出生体重为（3406±400）g。低出生体重和巨大儿的发生率分别为0.92%（152/16460）和7.55%（1242/16460）。体重过低组（n = 3089）、正常体重组（n = 11478）和超重组（n = 1893）的GWG分别为（17.4±4.6）kg、（17.3±4.8）kg和（15.6±5.3）kg。且GWG与子代出生体重呈正相关（P < 0.01）。三组间GWG、新生儿出生体重及巨大儿发生率差异有统计学意义（P < 0.01）。（2）三组中有8449例出生体重适宜的婴儿。其母亲在体重过低、正常体重和超重组中，推荐的GWG范围分别为14.0 - 19.5 kg、13.5 - 19.5 kg和11.0 - 18.0 kg。所有女性的推荐GWG为16.0 kg。（3）根据推荐的GWG，低GWG会增加低出生体重风险（OR = 1.589，95%CI：1.085 - 2.326）并降低巨大儿风险（OR = 0.500，95%CI：0.401 - 0.624）。过高的GWG会增加巨大儿风险（OR = 2.031，95%CI：1.789 - 2.306），但不会降低低出生体重风险（OR = 1.168，95%CI：0.774 - 1.764）。（4）对于体重过低、正常体重和超重组，通过ROC曲线分析得到的GWG范围分别为16.3 - 16.7 kg、15.6 - 17.8 kg和14.6 - 15.1 kg。对于所有三组，范围为15.6 - 16.7 kg。ROC曲线分析得到的范围均在推荐范围内。
GWG与子代出生体重呈正相关，适宜的GWG约为16.0 kg。
