Tulmaç Özlem B, Dağ Zeynep Ö, Erdoğan Funda, Sayan Cemile D, Sağsöz Nevin
Department of Obstetrics and Gynaecology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.
J Obstet Gynaecol Res. 2018 Mar;44(3):384-389. doi: 10.1111/jog.13548. Epub 2017 Dec 14.
We examined body mass index (BMI) and gestational weight gain (GWG) patterns of pregnant women and investigated the impact of these factors on the urinary albumin-creatinine ratio (ACR) during pregnancy.
The data of 163 women whose basal BMI and ACR were measured during the first trimester were used in this study. Body weight alone between 12-16 weeks and body weight together with ACR after 37 weeks of gestation were measured.
Overall, 46% of women were overweight or obese, 60.7% had excessive weight gain and 16.6% had inadequate weight gain. Only 22.7% of women gained weight within the recommended range. There was no difference in weight gain patterns with respect to BMI. ACR during the third trimester was significantly higher than during the first trimester (7.08 [0.00-1180.90] mg/g vs 4.73 [0.00-275.00] mg/g, respectively; P = 0.001). The ACR of obese women was higher than in normal weight subjects during the third trimester (16.79 mg/g [0.01-1180.90] vs 8.07 mg/g [0.10-402.14] respectively; adjusted P = 0.015). Both ACR change and third trimester ACR were weakly but significantly correlated with basal BMI (r: 0.228 P: 0.003 and r: 0.301 P < 0.001, respectively) but not with GWG or GWG rate. Basal BMI was not associated with first-trimester ACR.
Obesity is associated with an increase in urinary albumin excretion during the course of pregnancy. Distinction of this relationship during pregnancy offers an opportunity for further research on pathophysiological mechanisms. The alarmingly high rate of non-compliance with IOM guidelines in pregnant women is a concern. Prompt measures for counseling of women before and during pregnancy in order to maintain healthy weight are needed.
我们研究了孕妇的体重指数（BMI）和孕期体重增加（GWG）模式，并调查了这些因素对孕期尿白蛋白-肌酐比值（ACR）的影响。
本研究使用了163名在孕早期测量了基础BMI和ACR的女性的数据。测量了孕12至16周时的体重以及孕37周后的体重和ACR。
总体而言，46%的女性超重或肥胖，60.7%体重增加过多，16.6%体重增加不足。只有22.7%的女性体重增加在推荐范围内。体重增加模式在BMI方面无差异。孕晚期的ACR显著高于孕早期（分别为7.08[0.00 - 1180.90]mg/g和4.73[0.00 - 275.00]mg/g；P = 0.001）。孕晚期肥胖女性的ACR高于正常体重者（分别为16.79mg/g[0.01 - 1180.90]和8.07mg/g[0.10 - 402.14]；校正P = 0.015）。ACR变化和孕晚期ACR与基础BMI均呈弱但显著的相关性（r分别为0.228，P = 0.003和r为0.301，P < 0.001），但与GWG或GWG率无关。基础BMI与孕早期ACR无关。
肥胖与孕期尿白蛋白排泄增加有关。孕期明确这种关系为进一步研究病理生理机制提供了机会。孕妇不遵守美国医学研究所（IOM）指南的比例高得惊人，令人担忧。需要在孕前和孕期及时采取措施为女性提供咨询，以维持健康体重。
