Hediger M L, Scholl T O, Belsky D H, Ances I G, Salmon R W
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Camden.
Obstet Gynecol. 1989 Jul;74(1):6-12.
Early weight gain adequacy may be a particular problem among adolescent gravidas because of their tendency to poor prepregnant nutritional status, nutritionally poor diets during pregnancy, and body image concerns, but it is not known whether irregular patterns of weight gain during adolescent pregnancy are associated with birth weight and length of gestation. We studied weight gain during pregnancy and pregnancy outcome in a cohort of 1790 teenage gravidas from Camden, New Jersey. We found that early inadequate weight gain (less than 4.3 kg by 24 weeks' gestation) was associated with a significantly increased risk of having a small for gestational age infant (adjusted odds ratio 1.88; 95% confidence interval 1.08-3.27), even when later gains brought the cumulative total weight gain to within adult standards. Late inadequate gains (less than 400 g/week) were associated significantly with preterm delivery (before 37 completed weeks' gestation), whether or not the total gain was adequate for gestation (adjusted odds ratio 1.69; 95% confidence interval 1.12-2.55). These results suggest that supplementation, intervention, or prenatal care protocols for adolescents that do not focus on balanced weight gain during adolescent pregnancy may reduce preterm delivery but may not significantly affect the incidence of intrauterine growth retardation.
由于青春期孕妇孕前营养状况较差、孕期饮食营养不佳以及对身体形象的关注，早期体重增加是否充足可能是一个特殊问题，但尚不清楚青春期妊娠期间体重增加不规律的模式是否与出生体重和妊娠期长短相关。我们对来自新泽西州卡姆登的1790名青少年孕妇队列的孕期体重增加情况及妊娠结局进行了研究。我们发现，早期体重增加不足（妊娠24周时体重增加少于4.3千克）与出生时小于胎龄儿的风险显著增加相关（校正比值比为1.88；95%置信区间为1.08 - 3.27），即使后期体重增加使累积总增重达到成人标准。后期体重增加不足（每周少于400克）与早产（妊娠满37周前）显著相关，无论总增重是否符合妊娠要求（校正比值比为1.69；95%置信区间为1.12 - 2.55）。这些结果表明，针对青少年的补充营养、干预措施或产前护理方案若不关注青春期妊娠期间的均衡体重增加，可能会减少早产，但可能不会显著影响宫内生长迟缓的发生率。
