Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, United States.
Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, United States.
Pregnancy Hypertens. 2020 Apr;20:50-55. doi: 10.1016/j.preghy.2020.03.001. Epub 2020 Mar 3.
To examine the relationship of weight change during early, mid, and late pregnancy with the development of a hypertensive disorder of pregnancy (HDP).
These data are from a prospective cohort study of nulliparous women with live singleton pregnancies. "Early" weight change was defined as the difference between self-reported pre-pregnancy weight and weight at the first visit (between 6 and 13 weeks' gestation); "mid" weight change was defined as the weight change between the first and second visits (between 16 and 21 weeks' gestation); "late" weight change was defined as the weight change between the second and third visits (between 22 and 29 weeks' gestation). Weight change in each time period was further characterized as inadequate, adequate, or excessive based on the Institute of Medicine's (IOM's) trimester-specific weekly weight gain goals based on pre-pregnancy body mass index. Multivariable Poisson regression was performed to adjust for potential confounders.
Development of any hypertensive disorder of pregnancy.
Of 8296 women, 1564 (18.9%) developed a HDP. Weight gain in excess of the IOM recommendations during the latter two time periods was significantly associated with HDP. Specifically, trimester-specific excessive weight gain in the mid period (aIRR 1.16, 95% CI 1.01-1.35) as well as in the late period (aIRR = 1.19, 95% CI = 1.02-1.40) was associated with increased risk of developing HDP. The weight gain preceded the onset of clinically apparent disease.
Excessive weight gain as early as the early second trimester was associated with increased risks of development of HDP.
探讨妊娠早、中、晚期体重变化与妊娠高血压疾病（HDP）发展的关系。
这些数据来自一项前瞻性队列研究，研究对象为初产妇活单胎妊娠。“早期”体重变化定义为自我报告的孕前体重与首次就诊时的体重差异（妊娠 6-13 周）；“中期”体重变化定义为首次和第二次就诊之间的体重变化（妊娠 16-21 周）；“晚期”体重变化定义为第二次和第三次就诊之间的体重变化（妊娠 22-29 周）。根据美国医学研究所（IOM）基于孕前体重指数的特定孕期每周增重目标，将每个时间段的体重变化进一步定义为不足、足够或过多。采用多变量泊松回归调整潜在混杂因素。
任何妊娠高血压疾病的发生。
在 8296 名女性中，有 1564 名（18.9%）发生了 HDP。后两个时期体重增加超过 IOM 建议与 HDP 显著相关。具体而言，中期特定孕期体重过度增加（aIRR 1.16，95%CI 1.01-1.35）以及晚期体重过度增加（aIRR=1.19，95%CI=1.02-1.40）与 HDP 发病风险增加相关。体重增加发生在临床明显疾病出现之前。
早在妊娠中期早期就出现体重过度增加与 HDP 发病风险增加有关。
