Horng Huann-Cheng, Huang Ben-Shian, Lu Yen-Feng, Chang Wen-Hsun, Chiou Jyh-Shin, Chang Po-Lun, Lee Wen-Ling, Wang Peng-Hui
Department of Obstetrics and Gynecology.
Institute of BioMedical Informatics.
Medicine (Baltimore). 2018 Jan;97(4):e9711. doi: 10.1097/MD.0000000000009711.
Pregnancy weight gain may be associated with adverse pregnancy outcomes. The article aims to explore the relationship between weight change and pregnancy outcome in the Taiwanese pregnant women.The retrospective cohort study enrolled women with vertex singleton pregnancy at University-associated Hospital between 2011 and 2014. Pregnancy weight change was separated into 3 groups, based on the Institute of Medicine (IOM) guidelines: below (n = 221); within (n = 544); and above (n = 382). Analysis of variance, χ tests, generalized linear models, and logistic regression models were used for statistical comparisons.Pregnant women with weight change above IOM guidelines had a significant increase in both maternal and perinatal complications compared with normal controls (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.03-1.98; P = .043; OR 1.45, 95% CI 1.01-1.87; P = .049, respectively). This finding was not found in pregnant women with weight gain below IOM guidelines. Moreover, age (OR 1.08, 95% CI 1.02-1.15; P = .0011), pre-pregnancy weight (OR 1.04, 95% CI 1.01-1.09; P = .0008), pre-pregnancy body mass index (BMI; OR 1.15, 95% CI 1.06-1.30; P < .0001), weight at the time of delivery (OR 1.05, 95% CI 1.02-1.13; P < .0001) and BMI at the time of delivery (OR 1.15, 95% CI 1.06-1.39; P < .0001), all contributed to increased maternal complications but not perinatal complications, whereas parity (OR 0.23, 95% CI 0.12-0.41; P < .0001) and gestational age (OR 0.50, 95% CI 0.35-0.62; P < .001) were associated with fewer maternal complications.Our study reconfirmed that for Taiwanese pregnant women, the approximate pregnancy weight gain recommended by IOM in 2009 was associated with the fewest maternal and perinatal complications. If approximate pregnancy weight gain cannot be attained, even less weight gain during pregnancy is still reasonable without significantly and adversely affecting maternal and perinatal outcomes in Taiwan.
孕期体重增加可能与不良妊娠结局相关。本文旨在探讨台湾孕妇体重变化与妊娠结局之间的关系。这项回顾性队列研究纳入了2011年至2014年在大学附属医院单胎头位妊娠的女性。根据美国医学研究所（IOM）的指南，将孕期体重变化分为3组：低于（n = 221）；在范围内（n = 544）；高于（n = 382）。采用方差分析、χ检验、广义线性模型和逻辑回归模型进行统计比较。与正常对照组相比，体重变化高于IOM指南的孕妇，其母体并发症和围产期并发症均显著增加（优势比[OR] 1.65，95%置信区间[CI] 1.03 - 1.98；P = 0.043；OR 1.45，95% CI 1.01 - 1.87；P = 0.049）。而体重增加低于IOM指南的孕妇未发现此现象。此外，年龄（OR 1.08，95% CI 1.02 - 1.15；P = 0.0011）、孕前体重（OR 1.04，95% CI 1.01 - 1.09；P = 0.0008）、孕前体重指数（BMI；OR 1.15，95% CI 1.06 - 1.30；P < 0.0001）、分娩时体重（OR 1.05，95% CI 1.02 - 1.13；P < 0.0001）和分娩时BMI（OR 1.15，95% CI 1.06 - 1.39；P < 0.0001）均会导致母体并发症增加，但不会导致围产期并发症增加，而产次（OR 0.23，95% CI 0.12 - 0.41；P < 0.0001）和孕周（OR 0.50，95% CI 0.35 - 0.62；P < 0.001）与较少的母体并发症相关。我们的研究再次证实，对于台湾孕妇而言，如果按照IOM 2009年推荐的大致孕期体重增加量，母体和围产期并发症最少。如果无法达到大致的孕期体重增加量，在台湾，孕期体重增加较少在不显著且不利影响母体和围产期结局的情况下仍然是合理的。
