Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
J Obstet Gynaecol. 2021 Aug;41(6):864-869. doi: 10.1080/01443615.2020.1803242. Epub 2020 Oct 20.
The present study aimed to document the prevalence of and identify factors associated with excessive gestational weight gain (GWG) in early pregnancy among women with pre-pregnancy overweight or obesity. Women with pre-pregnancy overweight or obesity ( = 247) were recruited between 12 and 20 weeks of gestation and completed questionnaires and were weighed to estimate early GWG. Nearly one-third of women met (17%, = 42) or exceeded (13%, = 33) guidelines for total GWG in early pregnancy. Univariate analyses showed race, income, and pre-pregnancy weight status to be significantly related to GWG category in early pregnancy ( < .009). Only race and pre-pregnancy weight status remained significant in a multivariate model, with Black women and women with pre-pregnancy obesity having higher odds of having met or exceeded guidelines for total GWG in early pregnancy compared with White women and women with pre-pregnancy overweight ( < .04). These findings highlight the need for early intervention to reduce weight-related complications among pregnant women.Impact statement Women with pre-pregnancy overweight or obesity who gain excessive gestational weight early in pregnancy are at unique risk for pregnancy complications and adverse birth outcomes. The present study adds to a growing body of literature documenting that a notable amount of women are gaining excessive gestational weight early in pregnancy. The present study further documents that Black women and women with pre-pregnancy obesity are at particular risk of gaining excessive gestational weight early in pregnancy. Additional work examining modifiable risk factors, particularly among Black women and women with pre-pregnancy obesity, that contribute to excessive gestational weight gain (GWG) in the first half of pregnancy is warranted and will be necessary to inform interventions aimed at promoting weight loss during the preconception and interconception periods or encouraging appropriate GWG across the entire course of pregnancy.
本研究旨在记录超重或肥胖孕妇在妊娠早期体重过度增加（GWG）的流行情况，并确定与 GWG 相关的因素。在妊娠 12 至 20 周期间招募了超重或肥胖的孕妇（ = 247），并完成了问卷调查和称重，以估计早期 GWG。近三分之一的女性符合（17%， = 42）或超过（13%， = 33）早期妊娠总 GWG 的指南。单因素分析显示，种族、收入和孕前体重状况与妊娠早期 GWG 类别显著相关（ < .009）。仅种族和孕前体重状况在多变量模型中仍具有统计学意义，与白人女性和孕前超重的女性相比，黑人女性和孕前肥胖的女性在妊娠早期更有可能符合或超过总 GWG 的指南（ < .04）。这些发现强调需要早期干预，以减少孕妇与体重相关的并发症。
影响陈述 妊娠早期体重过度增加的超重或肥胖孕妇面临独特的妊娠并发症和不良出生结局风险。本研究增加了越来越多的文献记录，表明相当数量的女性在妊娠早期过度增加 GWG。本研究进一步记录了黑人女性和孕前肥胖的女性在妊娠早期特别容易过度增加 GWG。需要进一步研究可改变的危险因素，特别是在黑人女性和孕前肥胖的女性中，这些因素会导致妊娠早期过度增加 GWG，并将有助于告知旨在促进备孕和间孕期减肥或鼓励整个孕期适当 GWG 的干预措施。
