Zhang Yi, Wang Liping, Yin Chuanmin, Mu Kai, Niu Dayan, Yan Weili
Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.
Maternal and Infant Health Center, International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai, China.
BMJ Open. 2018 Jun 28;8(6):e019645. doi: 10.1136/bmjopen-2017-019645.
This study aimed to construct and validate smoothed gestational weight centile curves based on preconception weight status for Chinese pregnant women.
A retrospective study based on hospital routine data SETTING: Hospital prenatal care.
A cohort of pregnant Chinese women with preconception and gestational body weights without maternal or neonatal complications (sample 1, n=2992), and a non-selective independent sample (sample 2, n=7420), were selected from hospital routine data for curve construction and validation.
Smoothed body weight centile curves for each gestational week were constructed using the LMS method in sample 1. Validation in sample 2 included analysis of agreement between predicted weight at the 38th week and observed values using the Bland-Altman Index. Predictions were also compared with international curves.
Smoothed centile curves of gestational weight for the three preconception body mass index groups showed a similar non-linear increasing trend. The differences between predicted body weights and observed values were 0.66±1.58 kg, 0.14±1.61 kg and -0.54±2.06 kg in the underweight, normal weight and overweight groups, respectively. Bland-Altman Index values were 5.2%, 5.6% and 4.7% in the underweight, normal weight and overweight groups, respectively, with limits of agreement of -2.43.8 kg, -3.03.3 kg and -4.4~3.4 kg, respectively. These limits of agreement were narrower than those of available international curves.
Body weight percentiles for gestational weeks 0-42 were proposed for underweight, normal weight or overweight Chinese women. These curves could constitute a useful tool for individualised gestational weight management by predicting body weight at a later gestation phase.
本研究旨在构建并验证基于孕前体重状况的中国孕妇孕期体重百分位数平滑曲线。
基于医院常规数据的回顾性研究
医院产前保健
从医院常规数据中选取一组无母婴并发症的中国孕妇队列(样本1,n = 2992),以及一个非选择性独立样本(样本2,n = 7420),用于曲线构建和验证。
在样本1中使用LMS方法构建每个孕周的体重百分位数平滑曲线。样本2中的验证包括使用Bland-Altman指数分析第38周预测体重与观察值之间的一致性。预测值也与国际曲线进行了比较。
三个孕前体重指数组的孕期体重百分位数平滑曲线呈现相似的非线性增长趋势。体重不足、正常体重和超重组的预测体重与观察值之间的差异分别为0.66±1.58 kg、0.14±1.61 kg和-0.54±2.06 kg。体重不足、正常体重和超重组的Bland-Altman指数值分别为5.2%、5.6%和4.7%,一致性界限分别为-2.43.8 kg、-3.03.3 kg和-4.4~3.4 kg。这些一致性界限比现有的国际曲线更窄。
提出了体重不足、正常体重或超重的中国女性在0-42孕周的体重百分位数。这些曲线可通过预测孕晚期体重,为个体化孕期体重管理提供有用工具。