Luke Sabrina, Kirby Russell S, Wright Lauri
Department of Community and Family Health, University of South Florida, Tampa.
J Perinat Neonatal Nurs. 2016 Oct/Dec;34(4):292-301. doi: 10.1097/JPN.0000000000000160.
The effects of postpartum weight retention on gestational weight gain in successive pregnancies require elucidation. The purpose of the study was (1) to examine the association between postpartum weight retention and subsequent adherence to the Institute of Medicine gestational weight gain guidelines and (2) to determine whether the association varies by body mass index status and affects birth outcomes. Florida vital records for 2005-2010 were analyzed using χ tests and multivariable Poisson regression, adjusted for interpregnancy interval, tobacco use, maternal age, and race/ethnicity. Obese women who gained inadequate weight were more likely to retain weight between pregnancies than obese women who met or exceeded the recommended weight gain. Risks for preterm birth increased among women with inadequate weight and decreased among women with excessive weight gain. Gaining excessive weight was protective for small-for-gestational age infants in all body mass index categories but increased the risks for large-for-gestational age infants. Underweight and normal weight women who gained in excess were 40% more likely to develop hypertension than normal weight women who gained within the recommended amount. Obese women who retain or gain weight postpartum are at increased risk for inadequate weight gain in a successive pregnancy. Achieving Institute of Medicine-recommended gestational weight gain is essential for preventing adverse maternal and infant outcomes.
产后体重滞留对连续妊娠中孕期体重增加的影响有待阐明。本研究的目的是：（1）研究产后体重滞留与随后遵循医学研究所孕期体重增加指南之间的关联；（2）确定这种关联是否因体重指数状况而异，并影响分娩结局。利用χ检验和多变量泊松回归分析了2005 - 2010年佛罗里达州的生命记录，并对两次妊娠间隔、吸烟情况、产妇年龄和种族/民族进行了校正。孕期体重增加不足的肥胖女性比达到或超过推荐体重增加量的肥胖女性在两次妊娠之间更有可能滞留体重。体重不足的女性早产风险增加，而体重增加过多的女性早产风险降低。在所有体重指数类别中，体重增加过多对小于胎龄儿有保护作用，但增加了大于胎龄儿的风险。体重不足和体重正常但体重增加过多的女性患高血压的可能性比体重正常且体重增加量在推荐范围内的女性高40%。产后体重滞留或增加的肥胖女性在连续妊娠中体重增加不足的风险增加。实现医学研究所推荐的孕期体重增加对于预防母婴不良结局至关重要。
