Liu Jihong, Whitaker Kara M, Yu Stella M, Chao Shin M, Lu Michael C
Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Office of Research and Epidemiology, Maternal & Child Health Bureau, Health Resources & Services Administration, Rockville, Maryland.
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
Womens Health Issues. 2016 May-Jun;26(3):321-8. doi: 10.1016/j.whi.2016.01.004. Epub 2016 Feb 24.
This study sought to determine whether women's report of gestational weight gain (GWG) advice from a health care provider is consistent with the Institute of Medicine (IOM) guidelines and the association between provider advice and women's weight gain during pregnancy.
Data came from the 2007 Los Angeles Mommy and Baby study (n = 3,402). The 1990 IOM GWG guidelines were used to define whether the provider's advice on weight gain and women's weight gain were below, within, or above the guidelines.
Approximately 4 months after delivery, 18.8% of the women reported having not discussed weight gain with any health care providers during pregnancy. Among those who reported such discussions, 42% reported receiving weight gain advice from a health care provider within IOM guidelines, 16.5% below guidelines, and 10% above. An additional 13.5% reported the discussion but did not report the recommended weight gain amount. Compared with women who reported provider advice on weight gain within guidelines, women who reported advice below guidelines were 1.7 times (95% confidence interval [CI], 1.3-2.2) more likely to gain less than the IOM recommended amount. Women who reported provider advice above IOM guidelines were 2.0 times (95% CI, 1.4-2.9) more likely to exceed guidelines.
There is a need for more women to receive advice consistent with the IOM GWG guidelines from their prenatal care providers. Intervention strategies are needed to educate providers about IOM guidelines and how to counsel on GWG.
本研究旨在确定女性报告的来自医疗保健提供者的孕期体重增加（GWG）建议是否与医学研究所（IOM）指南一致，以及提供者建议与女性孕期体重增加之间的关联。
数据来自2007年洛杉矶母婴研究（n = 3402）。使用1990年IOM的GWG指南来定义提供者关于体重增加的建议以及女性的体重增加是低于、符合还是高于指南。
分娩后约4个月，18.8%的女性报告在孕期未与任何医疗保健提供者讨论过体重增加问题。在那些报告有此类讨论的女性中，42%报告从医疗保健提供者那里获得了符合IOM指南的体重增加建议，16.5%低于指南，10%高于指南。另外13.5%报告了讨论，但未报告推荐的体重增加量。与报告获得符合指南的体重增加建议的女性相比，报告低于指南建议的女性体重增加少于IOM推荐量的可能性高1.7倍（95%置信区间[CI]，1.3 - 2.2）。报告高于IOM指南建议的女性体重增加超过指南的可能性高2.0倍（95%CI，1.4 - 2.9）。
需要更多女性从产前护理提供者那里获得与IOM的GWG指南一致的建议。需要采取干预策略，教育提供者了解IOM指南以及如何就GWG提供咨询。
