Russell Amy, Gillespie Stephanie, Satya Suma, Gaudet Laura M
Faculty of Medicine, Dalhousie University, Saint John NB.
Division of Maternal Fetal Medicine, The Moncton Hospital, Moncton NB.
J Obstet Gynaecol Can. 2013 Sep;35(9):802-809. doi: 10.1016/S1701-2163(15)30836-7.
Maternity care providers can use pre-pregnancy weight (PPW) and gestational weight gain (GWG) as markers for difficult delivery, and frequently obtain this information directly from the patient. The goal of this study was to determine whether women report their PPW and GWG correctly at the end of pregnancy.
We performed a prospective cohort study of 189 women delivering between June 1, 2011, and July 31, 2011, at the Saint John Regional Hospital or the Moncton Hospital in New Brunswick. Self- reported PPW and GWG were compared with measured weights obtained from the antenatal chart and upon presentation for delivery. Patient characteristics, BMI classification, and accuracy and degree of error in recall were assessed.
The majority of respondents were under 30 years of age (63.4%) and were delivering at term (96.3%). Ninety women (47.6%) were having their first baby. A record of weight measured in the first trimester was available for 98 respondents (51.9%); using this information, 44 women (44.9%) were determined to be overweight or obese at delivery. Approximately one third of women with a normal BMI were not able to recall their PPW or GWG accurately (± 1 kg). Among all BMI classes, there was a consistent pattern of under-reporting of PPW (by a mean of 1.52 kg) and over-reporting of GWG (by a mean of 1.61 kg), but several extreme outliers were identified.
At the time of delivery, under-reporting of PPW and over-reporting of GWG are common and difficult to predict. Maternity care providers should be aware of this discrepant reporting of PPW and GWG and recognize the implications for intrapartum management and postpartum weight loss.
产科护理人员可将孕前体重（PPW）和孕期体重增加（GWG）作为难产的指标，并经常直接从患者处获取此信息。本研究的目的是确定女性在妊娠末期报告其PPW和GWG是否正确。
我们对2011年6月1日至2011年7月31日在新不伦瑞克省圣约翰地区医院或蒙克顿医院分娩的189名女性进行了一项前瞻性队列研究。将自我报告的PPW和GWG与从产前图表和分娩时获得的测量体重进行比较。评估患者特征、BMI分类以及回忆的准确性和误差程度。
大多数受访者年龄在30岁以下（63.4%），且足月分娩（96.3%）。90名女性（47.6%）生育第一胎。98名受访者（51.9%）有孕早期体重测量记录；利用该信息，44名女性（44.9%）在分娩时被确定为超重或肥胖。大约三分之一BMI正常的女性无法准确回忆其PPW或GWG（±1千克）。在所有BMI类别中，均存在PPW报告不足（平均少报1.52千克）和GWG报告过度（平均多报1.61千克）的一致模式，但发现了几个极端异常值。
分娩时，PPW报告不足和GWG报告过度很常见且难以预测。产科护理人员应意识到PPW和GWG的这种差异报告，并认识到其对产时管理和产后体重减轻的影响。
