Regina R. Davis, Sandra L. Hofferth, and Edmond D. Shenassa are with the Maternal and Child Health Program, Department of Family Science, University of Maryland, College Park. Regina R. Davis is also with the American Public Health Association, Washington, DC. Edmond D. Shenassa is also with the Department of Epidemiology, University of Maryland, College Park.
Am J Public Health. 2014 Feb;104 Suppl 1(Suppl 1):S90-5. doi: 10.2105/AJPH.2013.301425. Epub 2013 Dec 19.
We examined the association of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with risk of death during infancy using the Institute of Medicine's (IOM's) Pregnancy Weight Gain Guidelines.
We obtained maternal and infant data for 2004-2008 from 159,244 women with a singleton, full-term, live birth in the 41 states that participated in phase 5 of the Pregnancy Risk Assessment Monitoring System. We fit logistic regression models to estimate the association between prepregnancy BMI, GWG, and risk of death during infancy, controlling for confounders.
Only 34% of women gained the IOM-recommended amount of weight during pregnancy. Infants born to underweight, normal-weight, and overweight women with inadequate GWG had odds of mortality during infancy that were 6.18, 1.47, and 2.11 times higher, respectively, than those of infants born to women with adequate GWG. Infants born to obese women with excessive weight gain had a 49% decreased likelihood of mortality.
A significant association exists between inadequate GWG and infant death that weakens with increasing prepregnancy BMI; weight gain beyond the recommended amount appears to be protective against infant mortality.
本研究利用美国医学研究院（IOM）的妊娠体重增加指南，探讨孕前体重指数（BMI）和孕期体重增加（GWG）与婴儿期死亡风险的关系。
我们从参与妊娠风险评估监测系统第 5 阶段的 41 个州的 159244 名单胎足月活产妇女中获取了母婴数据。我们采用 logistic 回归模型，在控制混杂因素的情况下，估计了孕前 BMI、GWG 与婴儿期死亡风险之间的关系。
仅有 34%的妇女在孕期获得了 IOM 推荐的体重增加量。与 GWG 充足的妇女相比，GWG 不足的低体重、正常体重和超重妇女所生婴儿在婴儿期的死亡风险分别高出 6.18、1.47 和 2.11 倍。而 GWG 过量的肥胖妇女所生婴儿的死亡风险则降低了 49%。
GWG 不足与婴儿死亡之间存在显著关联，且随着孕前 BMI 的增加而减弱；体重增加超过推荐量似乎对婴儿死亡率具有保护作用。
