Johnson Jonetta L, Farr Sherry L, Dietz Patricia M, Sharma Andrea J, Barfield Wanda D, Robbins Cheryl L
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service Commissioned Corps, Atlanta, GA.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Am J Obstet Gynecol. 2015 Jun;212(6):806.e1-8. doi: 10.1016/j.ajog.2015.01.030. Epub 2015 Jan 28.
Achieving adequate gestational weight gain (GWG) is important for optimal health of the infant and mother. We estimate current population-based trends of GWG.
We analyzed data from the Pregnancy Risk Assessment Monitoring System for 124,348 women who delivered live infants in 14 states during 2000 through 2009. We examined prevalence and trends in GWG in pounds as a continuous variable, and within 1990 Institute of Medicine (IOM) recommendations (yes/no) as a dichotomous variable. We examined adjusted trends in mean GWG using multivariable linear regression and GWG within recommendations using multivariable multinomial logistic regression.
During 2000 through 2009, 35.8% of women gained within IOM GWG recommendations, 44.4% gained above, and 19.8% gained below. From 2000 through 2009, there was a biennial 1.0 percentage point decrease in women gaining within IOM GWG recommendations (P trend < .01) and a biennial 0.8 percentage point increase in women gaining above IOM recommendations (P trend < .01). The percentage of women gaining weight below IOM recommendations remained relatively constant from 2000 through 2009 (P trend = .14). The adjusted odds of gaining within IOM recommendations were lower in 2006 through 2007 (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and 2008 through 2009 (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) relative to 2000 through 2001.
Overall, from 2000 through 2009 the percentage of women gaining within IOM recommendations slightly decreased while mean GWG slightly increased. Efforts are needed to develop and implement strategies to ensure that women achieve GWG within recommendations.
实现充足的孕期体重增加(GWG)对婴儿和母亲的最佳健康状况至关重要。我们估计当前基于人群的GWG趋势。
我们分析了2000年至2009年期间在14个州分娩活产婴儿的124,348名妇女的妊娠风险评估监测系统数据。我们将GWG以磅为单位作为连续变量,以及在1990年医学研究所(IOM)建议范围内(是/否)作为二分变量来研究其患病率和趋势。我们使用多变量线性回归研究平均GWG的校正趋势,并使用多变量多项逻辑回归研究在建议范围内的GWG。
在2000年至2009年期间,35.8%的妇女的体重增加在IOM的GWG建议范围内;体重增加高于建议范围的妇女占44.4%,低于建议范围的占19.8%。从2000年到2009年,体重增加在IOM GWG建议范围内的妇女每两年下降1.0个百分点(P趋势<.01),体重增加高于IOM建议范围的妇女每两年增加0.8个百分点(P趋势<.01)。从2000年到2009年,体重增加低于IOM建议范围的妇女比例保持相对稳定(P趋势=.14)。相对于2000年至2001年,2006年至2007年(校正比值比,0.90;95%置信区间,0.85-0.96)和2008年至2009年(校正比值比,0.90;95%置信区间,0.85-0.96)体重增加在IOM建议范围内的校正几率较低。
总体而言,从2000年到2009年,体重增加在IOM建议范围内的妇女比例略有下降,而平均GWG略有增加。需要努力制定和实施策略,以确保妇女在建议范围内实现GWG。