Deputy Nicholas P, Sharma Andrea J, Kim Shin Y, Hinkle Stefanie N
Nutrition and Health Sciences Program, Laney Graduate School, Emory University, the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and the U.S. Public Health Service Commissioned Corps, Atlanta, Georgia; and the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Obstet Gynecol. 2015 Apr;125(4):773-781. doi: 10.1097/AOG.0000000000000739.
To estimate the prevalence of gestational weight gain adequacy according to the 2009 Institute of Medicine recommendations and examine demographic, behavioral, psychosocial, and medical characteristics associated with inadequate and excessive gain stratified by prepregnancy body mass index (BMI) category.
We used cross-sectional, population-based data on women delivering full-term (37 weeks of gestation or greater), singleton neonates in 28 states who participated in the 2010 or 2011 Pregnancy Risk Assessment Monitoring System. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for inadequate and excessive compared with adequate gain, stratified by prepregnancy BMI.
Overall, 20.9%, 32.0%, and 47.2% of women gained inadequate, adequate, and excessive gestational weight, respectively. Prepregnancy BMI was strongly associated with weight gain outside recommendations. Compared with normal-weight women (prevalence 51.8%), underweight women (4.2%) had decreased odds of excessive gain (adjusted OR 0.50, CI 0.40-0.61), whereas overweight and obese class I, II, and III (23.6%, 11.7%, 5.4%, and 3.5%, respectively) women had increased odds of excessive gain (adjusted OR range 2.07, CI 1.63-2.62 to adjusted OR 2.99, CI 2.63-3.40). Underweight and obese class II and III women had increased odds of inadequate gain (adjusted OR 1.25, CI 1.01-1.55 to 1.86, CI 1.45-2.36). Most characteristics associated with weight gain adequacy were demographic such as racial or ethnic minority status and education and varied by prepregnancy BMI. Notably, one behavioral characteristic-smoking cessation-was associated with excessive gain among normal-weight and obese women.
Most women gained weight outside recommendations. Understanding characteristics associated with inadequate or excessive weight gain may identify potentially at-risk women and inform much-needed interventions.
根据2009年医学研究所的建议评估孕期体重增加充足的患病率，并研究按孕前体重指数（BMI）类别分层的与体重增加不足和过多相关的人口统计学、行为、心理社会和医学特征。
我们使用了参与2010年或2011年妊娠风险评估监测系统的28个州中分娩足月（妊娠37周或更长时间）单胎新生儿的妇女的基于人群的横断面数据。我们估计了与充足体重增加相比体重增加不足和过多的调整优势比（OR）和95%置信区间（CI），并按孕前BMI分层。
总体而言，分别有20.9%、32.0%和47.2%的妇女孕期体重增加不足、充足和过多。孕前BMI与超出建议范围的体重增加密切相关。与体重正常的妇女（患病率51.8%）相比，体重过轻的妇女（4.2%）体重增加过多的几率降低（调整后的OR为0.50，CI为0.40 - 0.61），而超重和肥胖I、II和III级的妇女（分别为23.6%、11.7%、5.4%和3.5%）体重增加过多的几率增加（调整后的OR范围为2.07，CI为1.63 - 2.62至调整后的OR为2.99，CI为2.63 - 3.40）。体重过轻以及肥胖II级和III级的妇女体重增加不足的几率增加（调整后的OR为1.25，CI为1.01 - 1.55至1.86，CI为1.45 - 2.36）。与体重增加充足相关的大多数特征是人口统计学特征，如种族或族裔少数群体身份和教育程度，并且因孕前BMI而异。值得注意的是，一种行为特征——戒烟——与体重正常和肥胖妇女的体重增加过多有关。
大多数妇女的体重增加超出了建议范围。了解与体重增加不足或过多相关的特征可能有助于识别潜在的高危妇女，并为急需的干预措施提供依据。
