Davies Hr, Visser J, Tomlinson M, Rotheram-Borus Mj, Gissane C, Harwood J, LeRoux I
Division of Human Nutrition, Stellenbosch University.
Department of Psychology, Stellenbosch University.
South Afr J Clin Nutr. 2013;26(3):116-122. doi: 10.1080/16070658.2013.11734455.
The aim of this study was to investigate the ability of the gestational body mass index (BMI) method to screen for adverse birth outcomes and maternal morbidities.
This was a substudy of a randomised controlled trial, the Philani Mentor Mothers' study.
The Philani Mentor Mothers' study took place in a peri-urban settlement, Khayelitsha, between 2009 and 2010. Pregnant women living in the area in 2009-2010 were recruited for the study.
Maternal anthropometry (height and weight) and gestational weeks were obtained at baseline to calculate the gestational BMI, which is maternal BMI adjusted for gestational age. Participants were classified into four gestational BMI categories: underweight, normal, overweight and obese. Birth outcomes and maternal morbidities were obtained from clinic cards after the births.
Pregnant women were recruited into the study (n = 1 058). Significant differences were found between the different gestational BMI categories and the following birth outcomes: maternal (p-value = 0.019), infant hospital stay (p-value = 0.03), infants staying for over 24 hours in hospital (p-value = 0.001), delivery mode (p-value = 0.001), birthweight (p-value = 0.006), birth length (p-value = 0.007), birth head circumference (p-value = 0.007) and pregnancy-induced hypertension (p-value = 0.001).
To the best of our knowledge, this is the first study that has used the gestational BMI method in a peri-urban South African pregnant population. Based on the findings that this method is able to identify unfavourable birth outcomes, it is recommended that it is implemented as a pilot study in selected rural, peri-urban and urban primary health clinics, and that its ease and effectiveness as a screening tool is evaluated. Appropriate medical and nutritional advice can then be given to pregnant women to improve both their own and their infants' birth-related outcomes and maternal morbidities.
本研究旨在调查孕期体重指数（BMI）法筛查不良分娩结局及孕产妇发病情况的能力。
这是一项随机对照试验（菲拉尼指导母亲研究）的子研究。
菲拉尼指导母亲研究于2009年至2010年在城郊定居点凯伊利沙进行。招募了2009 - 2010年居住在该地区的孕妇参与研究。
在基线时获取孕产妇人体测量数据（身高和体重）及孕周，以计算孕期BMI，即根据孕周调整的孕产妇BMI。参与者被分为四个孕期BMI类别：体重过轻、正常、超重和肥胖。分娩后从诊所病历中获取分娩结局及孕产妇发病情况。
共有1058名孕妇被纳入研究。不同孕期BMI类别与以下分娩结局之间存在显著差异：孕产妇情况（p值 = 0.019）、婴儿住院时间（p值 = 0.03）、婴儿住院超过24小时（p值 = 0.001）、分娩方式（p值 = 0.001）、出生体重（p值 = 0.006）、出生身长（p值 = 0.007）、出生头围（p值 = 0.007）以及妊娠高血压（p值 = 0.001）。
据我们所知，这是第一项在南非城郊孕妇群体中使用孕期BMI法的研究。基于该方法能够识别不良分娩结局的研究结果，建议在选定的农村、城郊和城市初级卫生诊所开展试点研究，并评估其作为筛查工具的便捷性和有效性。然后可为孕妇提供适当的医疗和营养建议，以改善她们自身及婴儿与分娩相关的结局以及孕产妇发病情况。
