Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.
PLoS One. 2019 Feb 8;14(2):e0212116. doi: 10.1371/journal.pone.0212116. eCollection 2019.
To estimate the effect of inadequate maternal weight gain in the third trimester on the risk of intrauterine growth restriction (IUGR) in rural Bangladesh.
This study analyzed data from 1,463 mother-infant pairs in Matlab, Bangladesh which were available through the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). All the mothers were admitted to Matlab hospital for childbirth from January 2012 to December 2014, and they had singleton live births at term. Third-trimester weight gain (kg) was calculated by subtracting the estimated weight at the end of the second trimester from the weight taken before childbirth. Inadequate third-trimester weight gain was defined as 4 kg or less irrespective of pre-gravid nutritional status. IUGR was defined as a birth weight below 2500 g in full-term newborns (LBW-Term), and a birth weight for gestational age and infant sex less than the 10th percentile (SGA-10th) and 2 standard deviations below the mean birth weight (SGA-2SD) based on the international newborn standards from the INTERGROWTH-21st project. Multivariable logistic regression models were fitted to determine the independent effect of inadequate weight gain in the third trimester on the risk of IUGR.
A total of 824 (56.3%) women experienced inadequate weight gain in the third trimester of pregnancy. In this study, 215 (14.7%), 573 (39.2%) and 220 (15.0%) infants were born as LBW-Term, SGA-10th and SGA-2SD, respectively. In the multivariable logistic regression models, compared to adequate weight gain in the third-trimester, the odds ratios (OR) for LBW-Term, SGA-10th and SGA-2SD for inadequate weight gain were 1.8 (95% CI: 1.3, 2.5; p < 0.001), 1.4 (95% CI: 1.1, 1.8; p = 0.002) and 1.8 (95% CI: 1.3, 2.4; p = 0.001), respectively.
Both inadequate third-trimester weight gain and IUGR are prevailing public health concerns in rural Bangladesh. Inadequate weight gain in the third trimester substantially increased the risk of IUGR. Public health programs focusing on the promotion of adequate weight gain in the third trimester of pregnancy with an ultimate aim to decrease IUGR should be implemented.
评估孟加拉国农村地区孕妇孕晚期体重增加不足对宫内生长受限（IUGR）风险的影响。
本研究分析了孟加拉国 Matlab 的 1463 对母婴对的数据，这些数据可通过 Matlab 健康和人口监测系统以及孟加拉国国际腹泻病研究中心（icddr,b）Matlab 医院的电子数据库获得。所有母亲均于 2012 年 1 月至 2014 年 12 月在 Matlab 医院分娩，且她们均足月单胎活产。通过从孕中期末的估计体重中减去分娩前的体重来计算孕晚期体重增加（kg）。无论孕前营养状况如何，孕晚期体重增加不足定义为 4kg 或更少。宫内生长受限定义为足月新生儿（LBW-Term）出生体重低于 2500g，以及根据国际新生儿标准，出生体重与胎龄和婴儿性别低于第 10 百分位（SGA-10th）和低于平均出生体重 2 个标准差（SGA-2SD）。采用多变量逻辑回归模型确定孕晚期体重增加不足对 IUGR 风险的独立影响。
共有 824 名（56.3%）妇女在妊娠晚期体重增加不足。在本研究中，215 名（14.7%）、573 名（39.2%）和 220 名（15.0%）婴儿分别为 LBW-Term、SGA-10th 和 SGA-2SD。在多变量逻辑回归模型中，与孕晚期体重增加适量相比，体重不足的 LBW-Term、SGA-10th 和 SGA-2SD 的比值比（OR）分别为 1.8（95%CI：1.3，2.5；p<0.001）、1.4（95%CI：1.1，1.8；p=0.002）和 1.8（95%CI：1.3，2.4；p=0.001）。
孟加拉国农村地区的孕晚期体重不足和 IUGR 都是普遍存在的公共卫生问题。孕晚期体重增加不足会显著增加 IUGR 的风险。应实施以促进孕晚期体重增加为最终目标的公共卫生项目，以降低 IUGR 的发生。
