Department of Medicine, University of Otago, Dunedin, New Zealand.
Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
Obes Rev. 2020 Oct;21(10):e13056. doi: 10.1111/obr.13056. Epub 2020 Jul 6.
Gestational weight gain (GWG) is an important predictor of adverse pregnancy outcomes including gestational diabetes, preterm birth, delivery by caesarean and post-partum weight retention. The Institute of Medicine guidelines on GWG are widely adopted, and GWG is widely researched as an outcome of interest in lifestyle interventions during pregnancy. However, estimation of prepregnancy weight and measurement of weight prior to delivery introduce bias into measures of GWG. This review discusses the sources of bias in measures of GWG and the potential effect of bias on the relationship between adverse pregnancy outcomes associated with GWG. Bias in measures of GWG can be minimized by using measured weight at the first antenatal appointment in early pregnancy rather than self-reported prepregnancy weight and by adjusting for gestational age when the last weight is collected earlier than the delivery date. Bias owing to gestational age is an important potential confounder in the relationship between GWG and adverse pregnancy outcomes.
妊娠体重增加（GWG）是不良妊娠结局的重要预测因素，包括妊娠糖尿病、早产、剖宫产分娩和产后体重滞留。医学研究所关于 GWG 的指南被广泛采用，并且 GWG 作为妊娠期间生活方式干预的研究结果得到了广泛研究。然而，孕前体重的估计和分娩前体重的测量会给 GWG 的测量带来偏差。本综述讨论了 GWG 测量中的偏差来源，以及这种偏差对与 GWG 相关的不良妊娠结局之间关系的潜在影响。通过在早孕的第一次产前检查中使用测量的体重而不是自我报告的孕前体重，并在最后一次体重采集早于分娩日期时调整妊娠年龄，可以最大限度地减少 GWG 测量中的偏差。由于孕龄导致的偏差是 GWG 与不良妊娠结局之间关系的一个重要潜在混杂因素。
