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英国人群中妊娠体重过度增加的风险因素:一种生物心理社会模型方法。

Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach.

机构信息

Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK.

Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.

出版信息

BMC Pregnancy Childbirth. 2021 Jan 10;21(1):43. doi: 10.1186/s12884-020-03519-1.

Abstract

BACKGROUND

Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model.

METHODS

This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants.

RESULTS

In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25-43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG.

CONCLUSION

GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.

摘要

背景

妊娠体重增加(GWG)可能对母婴健康都有影响。然而,其影响因素尚不清楚。尽管使用生物心理社会方法有很多优势,但这种方法尚未应用于英国的 GWG 研究。本研究旨在采用生物心理社会模型,调查英国人群中 GWG 过多的危险因素。

方法

本研究利用了纵向 Grown in Wales(GiW)队列的数据,该队列在南威尔士招募了晚期妊娠的妇女。具体来说,数据来自助产士记录的笔记和在选择性剖宫产(ELCS)分娩前完成的广泛问卷。根据美国医学研究所(IOM)的指南对 GWG 进行分类。分析对象为 275 名参与者。

结果

在该人群中,56.0%的女性 GWG 过多。产前抑郁症状增加(Exp(B)=1.10,p=.019),超重(Exp(B)=4.16,p<.001)或肥胖(Exp(B)=4.20,p=.010)孕前 BMI、孕期饮酒(Exp(B)=.37,p=.005)和收入低于 18000 英镑(Exp(B)=.24,p=.043)和 25-43000 英镑(Exp(B)=.25,p=.002)与 GWG 过多有关。

结论

GWG 很复杂,受到多种生物心理社会因素的影响,本研究中人群 GWG 过度增长的高患病率令人担忧。英国的女性可能会受益于国民保健制度(NHS)中对 GWG 的修正方法,例如在整个孕期跟踪体重增加。此外,本研究为未来干预措施的潜在目标以及可能需要针对的高危人群提供了证据,以改善 GWG 结局。

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