Liang H, Zhang W Y, Li X T
Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.
Zhonghua Fu Chan Ke Za Zhi. 2017 Mar 25;52(3):147-152. doi: 10.3760/cma.j.issn.0529-567X.2017.03.002.
To investigate the influence of gestational weight gain (GWG) on the incidence of macrosomia, and to establish the reference ranges of GWG based on the incidence of macrosomia. A multicenter, cross-sectional study was conducted. Totally, 112 485 women were recruited from 39 hospitals in 14 provinces in China. Totally, 61 149 cases were eligible with singleton pregnancies and non-premature deliveries. The associations of pre-pregnancy body mass index (BMI), GWG, newborn gender and gestational diabetes with macrosomia were analyzed with logistic regression. The normal GWG ranges were calculated in all maternal BMI subgroups, based on the normal incidence of macrosomia was set as the range of 5.0% to 10.0%. In this study, the incidence of macrosomia was 7.46% (4 563/611 149). The macrosociam was positive related with maternal height, delivery week, pre-pregnancy BMI, GWG, gestational diabetes, primipara, and male babies significantly (0.05), based on unadjusted and adjusted logestic regression. The normal range of GWG 20.0-25.0, 10.0-20.0, 0-10.0 and 0-5.0 kg in subgroups of underweight (pre-pregnancy BMI<18.5 kg/m(2)), normal (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)) and obese (≥30.0 kg/m(2)), respectively. The reference range of GWG in China based on the incidence of macrosomia is established.
探讨孕期体重增加（GWG）对巨大儿发生率的影响，并基于巨大儿发生率建立GWG的参考范围。进行了一项多中心横断面研究。共从中国14个省份的39家医院招募了112485名女性。共有61149例单胎妊娠且非早产的病例符合条件。采用逻辑回归分析孕前体重指数（BMI）、GWG、新生儿性别和妊娠期糖尿病与巨大儿的相关性。根据设定的巨大儿正常发生率为5.0%至10.0%的范围，计算了所有母亲BMI亚组的正常GWG范围。在本研究中，巨大儿发生率为7.46%（4563/61149）。基于未调整和调整后的逻辑回归分析，巨大儿与母亲身高、分娩孕周、孕前BMI、GWG、妊娠期糖尿病、初产妇和男婴显著正相关（P<0.05）。体重过轻（孕前BMI<18.5kg/m²）、正常（18.5-24.9kg/m²）、超重（25.0-29.9kg/m²）和肥胖（≥30.0kg/m²）亚组的GWG正常范围分别为20.0-25.0、10.0-20.0、0-10.0和0-5.0kg。建立了基于巨大儿发生率的中国GWG参考范围。
