Bhavadharini Balaji, Anjana Ranjit Mohan, Deepa Mohan, Jayashree Gopal, Nrutya Subramanyam, Shobana Mahadevan, Malanda Belma, Kayal Arivudainambi, Belton Anne, Joseph Kurian, Rekha Kurian, Uma Ram, Mohan Viswanathan
Department of Diabetology and Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India.
Indian J Endocrinol Metab. 2017 Jul-Aug;21(4):588-593. doi: 10.4103/ijem.IJEM_557_16.
The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories.
Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied. Pregnancy outcomes were analyzed in relation to BMI and weight gain across different BMI categories.
Overweight and obese women who gained more weight during pregnancy were at high risk of delivering macrosomic infants (overweight - odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1-5.2, = 0.02 and obese - OR: 1.6, 95% CI: 1.1-2.4, = 0.01). In addition, obese women who gained more weight were also at high risk of preterm labor (OR: 2.1, 95% CI: 1.1-3.8; = 0.01), cesarean section (OR: 1.9, 95% CI: 1.4-2.5; < 0.001), and preeclampsia (OR: 2.8, 95% CI: 1.1-7.2, = 0.03). Normal weight and overweight women who gained less weight had a protective effect from cesarean section and macrosomia.
Overweight/obese women who gained more weight than recommended are at a high risk of developing adverse pregnancy outcomes. Normal and overweight women who gained weight less than recommended have low risk for cesarean section and macrosomia. However, they have a higher (statistically insignificant) risk for low birth weight and preterm birth. This highlights the need for gaining adequate weight during pregnancy.
本研究旨在比较不同体重指数（BMI）类别（采用世界卫生组织亚太地区BMI切点）的亚洲印度裔女性孕期体重增加情况（依据医学研究所指南），并比较不同BMI类别中的妊娠结局。
研究了2011年1月至2014年1月期间在印度南部金奈产前诊所和私立妇产中心就诊的2728名孕妇的回顾性记录。分析了妊娠结局与BMI以及不同BMI类别中体重增加的关系。
孕期体重增加较多的超重和肥胖女性分娩巨大儿的风险较高（超重 - 比值比[OR]：2.3，95%置信区间[CI]：1.1 - 5.2，P = 0.02；肥胖 - OR：1.6，95% CI：1.1 - 2.4，P = 0.01）。此外，体重增加较多的肥胖女性早产风险也较高（OR：2.1，95% CI：1.1 - 3.8；P = 0.01）、剖宫产风险较高（OR：1.9，95% CI：1.4 - 2.5；P < 0.001）以及患先兆子痫的风险较高（OR：2.8，95% CI：1.1 - 7.2，P = 0.03）。体重增加较少的正常体重和超重女性对剖宫产和巨大儿有保护作用。
体重增加超过推荐值的超重/肥胖女性发生不良妊娠结局的风险较高。体重增加低于推荐值的正常体重和超重女性剖宫产和巨大儿风险较低。然而，她们低出生体重和早产的风险较高（统计学上无显著差异）。这凸显了孕期适当增加体重的必要性。
