Raymond Jane E, Foureur Maralyn J, Davis Deborah L
J Midwifery Womens Health. 2014 Jul-Aug;59(4):398-404. doi: 10.1111/jmwh.12089. Epub 2014 May 29.
The prevalence of obesity in Australia among women of childbearing age has doubled over the past 2 decades. Obesity is associated with complications for women and their newborns during pregnancy and birth. Limiting gestational weight gain can reduce perinatal complications and postnatal weight retention, but evidence supporting interventions designed to assist obese pregnant women to manage their weight gain in pregnancy is inconclusive. The aim of this article is to describe the gestational weight change of a cohort of obese pregnant women enrolled in a group antenatal program aimed at assisting them to limit their weight gain in pregnancy to levels recommended by the US Institute of Medicine.
The program was jointly developed by 2 metropolitan maternity services in New South Wales, Australia. This is a descriptive study that presents select data for women enrolled in the program. Body mass index (BMI), prepregnancy weight, last pregnancy weight, and selected clinical outcomes were recorded for 82 obese women enrolled in the program during the evaluation period of 14 months. Data were analyzed using nonparametric tests: the chi-square and the Mann-Whitney U tests.
Parity was associated with prepregnancy BMI, with women of higher parity having higher BMIs. Women with higher BMIs had a significantly lower gestational weight gain than women with lower BMIs. Overall, 27% of women enrolled in the program gained the recommended 5 to 9 kg, 27% gained less than this amount, and 46% gained more.
Evidence supporting interventions designed to assist obese pregnant women to manage their weight gain in pregnancy is lacking. This innovative, collaborative program shows promise, as early results compare favorably with international comparisons.
在过去20年里,澳大利亚育龄妇女的肥胖率翻了一番。肥胖与女性及其新生儿在孕期和分娩期间的并发症相关。限制孕期体重增加可减少围产期并发症和产后体重滞留,但支持旨在帮助肥胖孕妇控制孕期体重增加的干预措施的证据尚无定论。本文旨在描述一组参加团体产前项目的肥胖孕妇的孕期体重变化情况,该项目旨在帮助她们将孕期体重增加控制在美国医学研究所建议的水平。
该项目由澳大利亚新南威尔士州的两家都市产科服务机构联合开发。这是一项描述性研究,呈现了参加该项目女性的部分数据。在14个月的评估期内,记录了参加该项目的82名肥胖女性的体重指数(BMI)、孕前体重、上次怀孕时的体重以及选定的临床结果。数据采用非参数检验进行分析:卡方检验和曼-惠特尼U检验。
产次与孕前BMI相关,产次较高的女性BMI较高。BMI较高的女性孕期体重增加显著低于BMI较低的女性。总体而言,参加该项目的女性中,27%的人体重增加了建议的5至9千克,27%的人体重增加少于这个量,46%的人体重增加更多。
缺乏支持旨在帮助肥胖孕妇控制孕期体重增加的干预措施的证据。这个创新的合作项目显示出了前景,因为早期结果与国际比较结果相比情况较好。