Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Paediatr Perinat Epidemiol. 2021 Mar;35(2):164-173. doi: 10.1111/ppe.12724. Epub 2020 Nov 6.
Expert groups recommend that women set a pregnancy weight gain goal with their care provider to optimise weight gain.
Our aim was to describe the concordance between first-trimester personal and provider pregnancy weight gain goals with the Institute of Medicine (IOM) recommendations and to determine the association between these goals and total weight gain.
We used data from 9353 women in the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be. In the first trimester, women reported their personal pregnancy weight gain goal and their provider weight gain goal, and we categorised personal and provider weight gain goals and total weight gain according to IOM recommendations. We used log-binomial or linear regression models to relate goals to total weight gain, adjusting for confounders including race/ethnicity, maternal age, education, smoking, marital status and planned pregnancy.
Approximately 37% of women reported no weight gain goals, while 24% had personal and provider goals, 31% had only a personal goal, and 8% had only a provider goal. Personal and provider goals were outside the recommended ranges in 12%-23% of normal-weight women, 31%-41% of overweight women and 47%-63% of women with obesity. Women with both personal and provider pregnancy weight gain goals were 6%-14% more likely than their counterparts to have a goal within IOM-recommended ranges. Having any goal or a goal within the IOM-recommended ranges was unrelated to pregnancy weight gain. Excessive weight gain occurred in approximately half of normal-weight or obese women and three-quarters of overweight women, regardless of goal setting group.
These findings do not support the effectiveness of early-pregnancy personal or provider gestational weight gain goal setting alone in optimising weight gain. Multifaceted interventions that address a number of mediators of goal setting success may assist women in achieving weight gain consistent with their goals.
专家组建议女性与医护人员共同设定孕期增重目标，以优化增重。
本研究旨在描述初孕期个人与医护人员的妊娠增重目标与医学研究所（IOM）建议的一致性，并确定这些目标与总增重之间的关系。
我们使用了来自 Nulliparous Pregnancy Outcomes Study：监测孕妇的 9353 名女性的数据。在孕早期，女性报告了她们的个人妊娠增重目标和医护人员的增重目标，我们根据 IOM 建议对个人和医护人员的增重目标和总增重进行了分类。我们使用对数二项式或线性回归模型来分析目标与总增重之间的关系，调整了种族/民族、产妇年龄、教育程度、吸烟状况、婚姻状况和计划妊娠等混杂因素。
约 37%的女性报告没有增重目标，而 24%的女性有个人和医护人员的目标，31%的女性只有个人目标，8%的女性只有医护人员的目标。在正常体重女性中，12%-23%、超重女性中 31%-41%和肥胖女性中 47%-63%的个人和医护人员的目标在推荐范围内之外。与没有目标或目标不在 IOM 推荐范围内的女性相比，有个人和医护人员妊娠增重目标的女性更有可能将目标设定在 IOM 推荐范围内，相差 6%-14%。设定任何目标或设定在 IOM 推荐范围内的目标与妊娠增重无关。超重或肥胖女性中有近一半、所有肥胖女性中有四分之三出现了过度增重，而不论目标设定组如何。
这些发现不支持仅通过孕早期个人或医护人员的妊娠增重目标设定来优化增重。多方面的干预措施可能会帮助女性实现与其目标一致的增重，这些措施可以解决目标设定成功的多个中介因素。
