Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore.
Office of Clinical Sciences, Duke-NUS Medical School, Singapore, Singapore.
BMC Pregnancy Childbirth. 2019 Aug 13;19(1):290. doi: 10.1186/s12884-019-2443-z.
We aimed to study gestational weight gain (GWG) in a Singaporean population and compare it with Institute of Medicine (IOM) 2009 GWG guidelines.
Nine hundred twenty-six women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital. Seven hundred twenty-four patients had maternal weight information till term pregnancy and were included in analysis. Participants were categorized according to their first antenatal visit body mass index (BMI) as underweight, normal weight, overweight and obese. Total GWG for each BMI group was calculated. Multivariate logistic regression was performed to determine the predictors of total GWG above and below IOM guidelines.
Obese women had a mean total GWG (9.1 kg) that exceeded the upper limit IOM guidelines (9 kg). In multivariate analysis of predictors of total GWG above IOM guidelines, being overweight (adjusted OR: 3.91 [95% CI, 2.60-5.88]; p < .0001) and obese (adjusted OR: 4.78 [95% CI, 2.80, 8.15]; p < .0001) significantly increased the risks of gaining weight above IOM guidelines during pregnancy, compared to being normal weight.
Overweight and obesity are independent significant risk factors for gaining excessive gestational weight. Appropriate weight management for overweight and obese Singaporean women prior to and during pregnancy is important.
本研究旨在调查新加坡人群的妊娠体重增加(GWG)情况,并将其与 2009 年美国医学研究所(IOM)GWG 指南进行比较。
2010 年至 2014 年,我们在一家新加坡的三级妇产医院进行了一项前瞻性队列研究,共纳入 926 例低危单胎妊娠的女性。其中 724 例患者在妊娠足月时有完整的体重信息,被纳入分析。根据首次产前检查时的体重指数(BMI)将参与者分为消瘦、正常体重、超重和肥胖。计算每个 BMI 组的总 GWG。采用多变量逻辑回归分析确定总 GWG 超过和低于 IOM 指南的预测因素。
肥胖女性的总 GWG(9.1kg)均值超过 IOM 指南的上限(9kg)。多变量分析显示,超重(调整后的比值比:3.91[95%置信区间:2.60-5.88];p<0.0001)和肥胖(调整后的比值比:4.78[95%置信区间:2.80-8.15];p<0.0001)与正常体重相比,显著增加了 GWG 超过 IOM 指南的风险。
超重和肥胖是妊娠期间体重过度增加的独立危险因素。对新加坡超重和肥胖女性进行适当的孕前和孕期体重管理非常重要。