Onwuka C I, Ugwu E O, Onah H E, Obi S N, Onwuka C I, Menuba I E, Okafor I I
Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Enugu Campus, Enugu; Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Department of Maxillofacial Surgery, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Niger J Clin Pract. 2017 Jun;20(6):754-760. doi: 10.4103/1119-3077.208958.
Despite the increasing global importance of gestational weight gain (GWG) and its impact on birthweight, little is known about the patterns of GWG in African populations.
To determine the pattern of GWG and its association with birthweight in Nigeria.
It was a longitudinal study of 200 pregnant women receiving antenatal care at two tertiary hospitals in Enugu, south eastern Nigeria. The women were consecutively recruited at <14 weeks gestation and their body mass indexes recorded upon recruitment. Thereafter, weight measurements were taken at each visit until 38-39 weeks.
Mean total GWG was 10.7 ± 3.4 kg, while mean birthweight was 3.3 ± 0.6 kg. GWG in second trimester had positive correlation with birthweight (r = 0.164, P = 0.02). Obese women gained above the recommended limits by the "institute of medicine" while underweight women gained below the limits. Excessive total GWG was associated with higher risk of macrosomia [8/21 (38.1%) vs. 7/179; RR: 9.74; 95% CI: 3.9-24.2; P < 0.001] while inadequate total GWG was associated with higher risk of low birth weight [7/72 (9.7%) vs. 3/128 (2.3%; RR: 4.15; 95% CI: 1.1-15.4; P = 0.03]. Maternal age of <35 years, high social class, nulliparity, and regular antenatal care were associated with normal GWG while maternal age <35 years and regular antenatal care were associated with normal birthweight (P < 0.05).
Women should be counseled on the factors that influence GWG and birthweight. Interventions to assist women achieve appropriate GWG may need to include components related to improved dietary intake for the underweight and increased physical activity for the obese.
尽管孕期体重增加（GWG）在全球范围内的重要性日益凸显，且其对出生体重有影响，但对于非洲人群的GWG模式却知之甚少。
确定尼日利亚的GWG模式及其与出生体重的关联。
这是一项对在尼日利亚东南部埃努古的两家三级医院接受产前护理的200名孕妇进行的纵向研究。这些妇女在妊娠<14周时连续招募，并在招募时记录其体重指数。此后，在每次就诊时进行体重测量，直至38 - 39周。
平均总GWG为10.7±3.4千克，而平均出生体重为3.3±0.6千克。孕中期的GWG与出生体重呈正相关（r = 0.164，P = 0.02）。肥胖妇女的体重增加超过了“医学研究所”推荐的限度，而体重过轻的妇女则低于该限度。总GWG过多与巨大儿风险较高相关[8/21（38.1%）对7/179；RR：9.74；95%CI：3.9 - 24.2；P < 0.001]，而总GWG不足与低出生体重风险较高相关[7/72（9.7%）对3/128（2.3%）；RR：4.15；95%CI：1.1 - 15.4；P = 0.03]。母亲年龄<35岁、社会阶层高、初产和定期产前护理与正常GWG相关，而母亲年龄<35岁和定期产前护理与正常出生体重相关（P < 0.05）。
应就影响GWG和出生体重的因素对妇女进行咨询。协助妇女实现适当GWG的干预措施可能需要包括与改善体重过轻妇女的饮食摄入以及增加肥胖妇女的身体活动相关的内容。
