澳大利亚原住民女性队列中孕期体重增加特征的再版。
Reprint of characterizing gestational weight gain in a cohort of indigenous Australian women.
作者信息
Schumacher Tracy L, Weatherall Loretta, Keogh Lyniece, Sutherland Kathryn, Collins Clare E, Pringle Kirsty G, Rae Kym M
机构信息
Gomeroi gaayngal Centre, Faculty of Health and Medicine, University of Newcastle, 2/1 Hinkler Rd, Tamworth, NSW 2340, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Ring Rd, Callaghan, NSW 2308, Australia.
Gomeroi gaayngal Centre, Faculty of Health and Medicine, University of Newcastle, 2/1 Hinkler Rd, Tamworth, NSW 2340, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
出版信息
Midwifery. 2019 Jul;74:148-156. doi: 10.1016/j.midw.2018.11.004. Epub 2018 Dec 14.
OBJECTIVE
to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index.
DESIGN
analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregnancy.
SETTING
women recruited through antenatal clinics in regional and remote towns in NSW, Australia to the Gomeroi gaaynggal program.
PARTICIPANTS
110 pregnant women who either identified as being an Indigenous Australian or as carrying an Indigenous child.
MEASUREMENTS AND FINDINGS
measurements included weight and height, self-reported pre-pregnancy weight and smoking status, parity and health conditions that may contribute to gestational weight gain, such as hypertensive or diabetic disorders. Compared to the 2009 Institute of Medicine recommendations for gestational weight gain and based on pre-pregnancy body mass index, the rate of adequate gestational weight gain in this cohort was low (26%). 33% of women had inadequate weight gain and 41% had excessive weight gain. The highest rate of excessive gestational weight gain was found in overweight women (65%), with rates of 39% and 31% found in healthy and obese (all classes) categories, respectively. Parity (coefficient 4.2, p < 0.01) and hypertension (coefficient 4.3, p = 0.049) were found to be significantly associated with gestational weight gain in mixed model linear regression.
CONCLUSIONS
few women gained adequate gestational weight gain in this study. Culturally acceptable ways of addressing this issue are needed for this group of women, as inadequate and excessive rates of gestational weight gain have health implications for women and their offspring.
IMPLICATIONS FOR PRACTICE
a systematic approach to addressing gestational weight gain within antenatal care is required, including asking about diet and exercise, for all women identifying as Indigenous Australian.
目的
确定一群澳大利亚原住民妇女孕期体重增加是否充足，并调查其与孕前体重指数是否相关。
设计
对一项纵向队列研究收集的观察数据进行分析，该研究跟踪澳大利亚原住民妇女的孕期情况。
地点
通过澳大利亚新南威尔士州地区和偏远城镇的产前诊所招募到参加戈梅罗伊盖英加尔项目的妇女。
参与者
110名孕妇，她们要么自认为是澳大利亚原住民，要么怀有原住民子女。
测量与结果
测量内容包括体重和身高、自我报告的孕前体重和吸烟状况、产次以及可能影响孕期体重增加的健康状况，如高血压或糖尿病。与2009年医学研究所关于孕期体重增加的建议相比，并根据孕前体重指数，该队列中孕期体重增加充足的比例较低（26%）。33%的妇女体重增加不足，41%的妇女体重增加过多。超重妇女孕期体重增加过多的比例最高（65%），健康和肥胖（所有类别）妇女的这一比例分别为39%和31%。在混合模型线性回归中，发现产次（系数4.2，p<0.01）和高血压（系数4.3，p = 0.049）与孕期体重增加显著相关。
结论
本研究中很少有妇女孕期体重增加充足。对于这群妇女，需要采用文化上可接受的方式来解决这个问题，因为孕期体重增加不足和过多对妇女及其后代的健康都有影响。
对实践的启示
对于所有自认为是澳大利亚原住民的妇女，在产前护理中需要采用系统方法来解决孕期体重增加问题，包括询问饮食和运动情况。
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