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中国西南地区女性孕前体重指数、孕期体重增加与新生儿出生体重之间的关系:一项前瞻性队列研究

[Relations between pregestational body mass index, gestational weight gain and birth weight of neonates among women in the Southwest areas of China: A prospective cohort study].

作者信息

Li D T, Liang Y, Gong Y H, Chen M X, Feng P, Yang D G, Yang W Y, Liu Y, Cheng G

机构信息

Department of Nutrition, Food Safety and Toxicology, West China School of Public Health.

Department of Obstetrics and Gynecology, West China Second University Hospital.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Oct 10;39(10):1319-1323. doi: 10.3760/cma.j.issn.0254-6450.2018.10.006.

Abstract

To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates. A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight, normal weight, overweight and obesity, according to the WHO Recommendation on BMI Classification. Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG. Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG, on the birth weight of the neonates. After adjusting for related confounders, low pre-gestational BMI appeared as a risk factor for SGA (=1.91, 95: 1.47-2.50), and was also associated with the decreased risk of LGA (=0.55, 95: 0.47-0.66). Inadequate GWG was both associated with the increased risk of delivering SGA (=1.57, 95: 1.21-2.03) and the decreased risk of LGA (=0.48, 95: 0.41-0.57). Pre-gestational overweight/obesity (=1.85, 95: 1.58-2.17) and excessive GWG (=1.87, 95: 1.67- 2.11) were both positively associated with the risks on LGA. Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all <0.05), but not with those overweight/obese women. Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates. Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.

摘要

探讨孕前体重指数(BMI)和孕期体重增加(GWG)对新生儿出生体重的影响。从中国西南地区(四川/云南/贵州)选取了5395名孕妇,根据世界卫生组织(WHO)关于BMI分类的建议,将她们分为孕前体重过轻、正常体重、超重和肥胖组。采用美国医学研究所的孕期体重指南来确认GWG的准确性。使用多项逻辑回归模型评估孕前BMI和GWG与新生儿出生体重之间的关联。在调整相关混杂因素后,孕前低BMI是小于胎龄儿(SGA)的危险因素(比值比=1.91,95%置信区间:1.47-2.50),并且也与大于胎龄儿(LGA)风险降低相关(比值比=0.55,95%置信区间:0.47-0.66)。GWG不足既与分娩SGA风险增加相关(比值比=1.57,95%置信区间:1.21-2.03),也与LGA风险降低相关(比值比=0.48,95%置信区间:0.41-0.57)。孕前超重/肥胖(比值比=1.85,95%置信区间:1.58-2.17)和GWG过多(比值比=1.87,95%置信区间:1.67-2.11)均与LGA风险呈正相关。分层分析数据表明,GWG不足与体重过轻或正常体重女性的SGA风险呈正相关(均P<0.05),但与超重/肥胖女性无关。孕前BMI和GWG是新生儿出生体重的重要影响因素。应加强对孕妇的健康教育,同时也应合理控制孕期体重增加。

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