Primary Health Care Corporation, Doha, Qatar.
Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
PLoS One. 2019 Jul 2;14(7):e0219248. doi: 10.1371/journal.pone.0219248. eCollection 2019.
Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48-6.91; OR: 2.84, CI: 1.15-7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.
越来越多的证据表明，母体营养状况对胎儿发育、出生结局和儿童健康起着重要作用。母婴营养评估 (MINA) 队列是一项针对卡塔尔和黎巴嫩孕妇及其子女的为期 3 年的随访研究。本研究报告了 MINA 参与者的孕前 BMI 和妊娠期体重增加 (GWG) 的特征和决定因素，以及出生结局。共有 272 名孕妇在孕早期分别从贝鲁特的初级保健中心和私人诊所（n=194）以及多哈（n=147）招募。在第一次就诊时，收集了包括孕前体重、社会人口统计学和生活方式特征在内的数据。从病历中提取了分娩前的体重和新生儿结局。GWG 计算为分娩前体重与孕前体重的差值，并按照 IOM 标准分为不足、充足和过多。总体而言，42.1%的女性孕前 BMI≥25kg/m2（卡塔尔为 58%，黎巴嫩为 30.8%，p<0.001）。只有 30.2%的女性有足够的 GWG，而分别有 25.7%和 44.1%的女性 GWG 不足和过多。在该队列中，68.7%的婴儿体重为适合胎龄（AGA），6.7%为 SGA，24.6%为 LGA。GWG 越大，LGA 的比例越高（p<0.05）。调整后，卡塔尔女性在怀孕前超重或肥胖的可能性是黎巴嫩女性的 3 倍，而较高的教育水平与孕前 BMI≥25kg/m2 的可能性显著降低相关。孕前 BMI≥25kg/m2 和经常吃早餐是 GWG 过多的预测因素（OR：3.20，95%CI：1.48-6.91；OR：2.84，95%CI：1.15-7.02）。MINA 参与者孕前超重和 GWG 过多的高发生率突出表明，需要制定针对特定文化的干预计划，以促进育龄妇女的健康体重，并防止怀孕期间体重过度增加。
