Cheng Hsiu-Rong, Walker Lorraine O, Brown Adama, Lee Ju-Young
Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.
The University of Texas at Austin, School of Nursing, Austin, Texas.
Womens Health Issues. 2015 May-Jun;25(3):303-11. doi: 10.1016/j.whi.2015.01.003. Epub 2015 Mar 31.
Asian-American subgroups are heterogeneous, but few studies had addressed differences on gestational weight gain (GWG) and perinatal outcomes related to GWG among this growing and diverse population. The purposes of this study were to examine whether Asian-American women are at higher risk of inadequate or excessive GWG and adverse perinatal outcomes than non-Hispanic White (NH-White) women, and to compare those risks among Asian-American subgroups.
This retrospective study included all singleton births to NH-Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnam, and NH-White women documented in 2009 Texas birth certificate data (N = 150,674). Data were analyzed using the χ(2) test, t test, multinomial logistic regression, and binary logistic regression. Chinese women were the reference group in the comparisons among Asian subgroups.
Asian women had a higher risk of inadequate GWG and gestational diabetes mellitus (GDM) than NH-White women. No difference in the odds of excessive GWG was found among Asian subgroups, although Japanese women had the highest risk of inadequate GWG. After adjusting for confounders, Korean women had the lowest risk of GDM (adjusted odds ratio [AOR], 0.49), whereas Filipino women and Asian Indian had the highest risks of gestational hypertension (AOR, 2.01 and 1.61), cesarean birth (AOR, 1.44 and 1.39), and low birth weight (AOR, 1.94 and 2.51) compared with Chinese women.
These results support the heterogeneity of GWG and perinatal outcomes among Asian-American subgroups. The risks of adverse perinatal outcomes should be carefully evaluated separately among Asian-American subpopulations.
亚裔美国人亚组具有异质性，但在这个不断增长且多样化的群体中，很少有研究探讨孕期体重增加（GWG）的差异以及与GWG相关的围产期结局。本研究的目的是检验亚裔美国女性与非西班牙裔白人（NH-白人）女性相比，体重增加不足或过多以及不良围产期结局的风险是否更高，并比较亚裔美国亚组之间的这些风险。
这项回顾性研究纳入了2009年得克萨斯州出生证明数据中记录的所有NH-亚裔印度人、中国人、菲律宾人、日本人、韩国人、越南人和NH-白人女性的单胎分娩（N = 150,674）。使用χ(2)检验、t检验、多项逻辑回归和二元逻辑回归对数据进行分析。在亚裔亚组的比较中，中国女性为参照组。
亚裔女性体重增加不足和妊娠期糖尿病（GDM）的风险高于NH-白人女性。尽管日本女性体重增加不足的风险最高，但在亚裔亚组中未发现体重增加过多的几率存在差异。在调整混杂因素后，韩国女性患GDM的风险最低（调整后的优势比[AOR]为0.49），而与中国女性相比，菲律宾女性和亚裔印度人患妊娠期高血压（AOR分别为2.01和1.61）、剖宫产（AOR分别为1.44和1.39）以及低出生体重（AOR分别为1.94和2.51）的风险最高。
这些结果支持了亚裔美国亚组中GWG和围产期结局的异质性。应在亚裔美国亚人群体中分别仔细评估不良围产期结局的风险。
