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连续两次妊娠的孕期特异性和总增重。

Trimester-Specific and Total Gestational Weight Gain in Two Consecutive Pregnancies.

机构信息

School of Nutrition, Laval University, Québec City, QC; Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC; Centre de recherche Nutrition, Santé et Société (NUTRISS), INAF, Laval University, Québec City, QC.

Faculté des sciences, Département de mathématiques, Université de Sherbrooke, Sherbrooke, QC; Centre de recherche du CHU de Sherbrooke, axe Santé: Populations, Organisation, Pratiques, Sherbrooke, QC.

出版信息

J Obstet Gynaecol Can. 2021 Apr;43(4):483-489.e3. doi: 10.1016/j.jogc.2020.12.009. Epub 2020 Dec 24.

Abstract

OBJECTIVE

This retrospective study aimed to characterize trimester-specific and total gestational weight gain (GWG) over the course of two consecutive pregnancies, as well as maternal determinants associated with interpregnancy weight change (IPWC) and excessive GWG in the second pregnancy.

METHODS

We analyzed the electronic medical records of women who delivered their first two consecutive infants at term between 2001 and 2017.

RESULTS

Weight gain trajectories differed between the first and second pregnancy for the 1497 women included in this study, with lower second- and third-trimester weight gain in the second pregnancy. Respectively, 53% and 41% of women had excessive GWG in the first and second pregnancies, with a higher proportion of excessive GWG found in women with a higher body mass index (BMI). Most women (55%) experienced interpregnancy weight gain. Maternal determinants of IPWC were BMI before first pregnancy, first-trimester and total GWG in the first pregnancy, and interpregnancy interval (P < 0.0001). Maternal risk factors associated with excessive GWG in the second pregnancy were excessive total GWG in the first pregnancy (OR 6.23; 95% CI 4.67-8.32), interpregnancy weight gain (OR 1.58; 95% CI 1.19-2.09), and interpregnancy interval (OR 1.18; 95% CI 1.07-1.29) as well as BMI before the second pregnancy (OR 1.04, 95% CI 1.02-1.07).

CONCLUSION

Weight gain trajectories differ between consecutive pregnancies. GWG in the first pregnancy is a key determinant for IPWC and GWG in the second pregnancy.

摘要

目的

本回顾性研究旨在描述连续两次妊娠过程中特定孕期和总孕期体重增加(GWG)的特征,以及与两次妊娠间体重变化(IPWC)和第二次妊娠过度 GWG 相关的产妇决定因素。

方法

我们分析了 2001 年至 2017 年间在足月时连续分娩头两胎的 1497 名女性的电子病历。

结果

在本研究纳入的 1497 名女性中,两次妊娠的体重增长轨迹不同,第二次妊娠的第二和第三孕期体重增长较低。分别有 53%和 41%的女性在第一和第二孕期出现 GWG 过度,BMI 较高的女性中发现 GWG 过度的比例更高。大多数女性(55%)经历了两次妊娠间的体重增加。IPWC 的产妇决定因素为第一次妊娠前的 BMI、第一次妊娠的第一孕期和总 GWG 以及两次妊娠间的间隔(P < 0.0001)。与第二次妊娠过度 GWG 相关的产妇危险因素是第一次妊娠的总 GWG 过度(OR 6.23;95% CI 4.67-8.32)、两次妊娠间的体重增加(OR 1.58;95% CI 1.19-2.09)和两次妊娠间的间隔(OR 1.18;95% CI 1.07-1.29)以及第二次妊娠前的 BMI(OR 1.04,95% CI 1.02-1.07)。

结论

连续妊娠的体重增长轨迹不同。第一次妊娠的 GWG 是两次妊娠间体重变化和第二次妊娠 GWG 的关键决定因素。

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