Schlaff Rebecca A, Holzman Claudia, Maier Kimbery S, Pfeiffer Karin A, Pivarnik James M
Saginaw Valley State University, 7400 Bay Road, H213 University Center, MI 48710, USA.
Michigan State University, 909 Fee Rd., Room 646, East Lansing, MI 48824, USA.
Midwifery. 2014 Nov;30(11):1124-31. doi: 10.1016/j.midw.2014.03.014. Epub 2014 Mar 28.
the purpose of this study was to examine associations among gestational weight gain (GWG) and pregnancy leisure-time physical activity (LTPA), within pre-pregnancy body mass index (BMI) categories, while utilising two different estimates of pre-pregnancy weight.
a cohort study. Data were collected via questionnaire and abstraction from birth certificate as a part of a larger study.
three antenatal clinics in Lansing, Michigan, USA.
a subset of women who participated in the Archive for Research on Child Health (ARCH) study and delivered a singleton, term infant (n=135). Participants were enroled prior to 14 weeks׳ gestation.
pre-pregnancy BMI was categorised as normal, overweight and obese (excluded underweight). GWG was calculated by subtracting pre-pregnancy weight from weight at childbirth (obtained from birth certificate) and classified as 'excess' or 'not excess' using the upper limit of the 2009 IOM recommended range. These two variables were constructed twice, first by using pre-pregnancy weight self-reported at enrolment and second, by using pre-pregnancy weight recorded on birth certificates. LTPA, also self-reported at enrolment, was modelled using two thresholds, moderate LTPA, and vigorous LPTA.
overall, 56-60% of our sample experienced excess GWG, depending on the source used for pre-pregnancy weight. Overweight and obese women had significantly higher odds of excess GWG (compared to normal weight women; Odds Ratio (OR)=2.48-5.34). LTPA level did not differ among pre-pregnancy BMI categories and was not related to appropriateness of GWG.
regardless of the source of pre-pregnancy weight, overweight and obese women were more likely to experience excess GWG (compared to normal weight women) and LTPA was not significantly related to the appropriateness of GWG.
findings highlight the need for practitioners to effectively communicate GWG recommendations and counsel women about the importance of achieving appropriate GWG. Although GWG counselling has traditionally been focused on obese women, these results suggest overweight women are in need of GWG counselling as well.
本研究旨在探讨在不同孕前体重指数（BMI）类别中，孕期体重增加（GWG）与孕期休闲体力活动（LTPA）之间的关联，同时使用两种不同的孕前体重估计值。
队列研究。作为一项更大规模研究的一部分，通过问卷调查和出生证明摘要收集数据。
美国密歇根州兰辛市的三家产前诊所。
参与儿童健康研究档案（ARCH）研究并分娩单胎足月儿的女性子集（n = 135）。参与者在妊娠14周前入组。
孕前BMI分为正常、超重和肥胖（排除体重过轻）。GWG通过从分娩时体重（从出生证明获得）中减去孕前体重来计算，并使用2009年美国医学研究所（IOM）推荐范围的上限将其分类为“过量”或“不过量”。这两个变量构建了两次，第一次使用入组时自我报告的孕前体重，第二次使用出生证明上记录的孕前体重。LTPA也是在入组时自我报告的，使用两个阈值进行建模，即中度LTPA和剧烈LTPA。
总体而言，根据用于孕前体重的来源，我们样本中的56% - 60%经历了过量的GWG。超重和肥胖女性过量GWG的几率显著更高（与正常体重女性相比；优势比（OR）= 2.48 - 5.34）。孕前BMI类别之间的LTPA水平没有差异，并且与GWG是否合适无关。
无论孕前体重的来源如何，超重和肥胖女性比正常体重女性更有可能经历过量的GWG，并且LTPA与GWG是否合适没有显著关系。
研究结果强调从业者需要有效地传达GWG建议，并就实现适当GWG的重要性向女性提供咨询。尽管传统上GWG咨询主要针对肥胖女性，但这些结果表明超重女性也需要GWG咨询。
