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孕期体重增加可能会影响围产期结局、孕期生活质量和生育费用:一项观察性队列研究。

Pregnancy weight gain may affect perinatal outcomes, quality of life during pregnancy, and child-bearing expenses: an observational cohort study.

机构信息

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan, Taiwan.

College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.

出版信息

Arch Gynecol Obstet. 2021 Sep;304(3):599-608. doi: 10.1007/s00404-021-05983-2. Epub 2021 Mar 4.

Abstract

PURPOSE

We aimed to examine the effect of gestational weight gain (GWG) on perinatal outcomes, quality of life (QoL) during pregnancy, and medical costs of childbirth.

METHODS

The observational cohort comprised 2210 pregnant women who were classified into three groups based on their pre-pregnancy body mass index (BMI) and GWG in relation to the 2020 Institute of Medicine (IOM) recommendations. The data were collected on perinatal outcomes, urinary incontinence (UI) during pregnancy, changes in sexual function, and medical costs of hospitalization for delivery. Univariate and multivariable logistic regression models were employed to explore those associations.

RESULTS

Only 42.1% of women met the 2020 IOM guidelines. After adjustments for potential confounding factors, women with above-normal GWG had adverse pregnancy outcomes, including a large fetal head circumference and macrosomia, and women with below-normal GWG were more likely to deliver low-birthweight fetuses preterm than women with normal GWG. Only 16.8% of women reported sexual activity during pregnancy. There were not significant differences in sexual activity and satisfaction, or QoL among the three GWG groups. Child-bearing expenses were higher for women with above-normal GWG than for women with normal GWG. Although the child-bearing expenses were higher for the above-normal GWG, the proportion of women with expenses above the median increased according to pre-pregnancy BMI.

CONCLUSION

Our results show that inappropriate GWG is associated with a greater risk of adverse perinatal outcomes and increased medical expenses for delivery. Healthcare providers are advised to counsel women to maintain their GWG following the 2020 IOM recommendations throughout pregnancy.

摘要

目的

本研究旨在探讨妊娠期体重增加(GWG)对围产期结局、妊娠期间生活质量(QoL)以及分娩医疗费用的影响。

方法

本观察性队列研究纳入了 2210 名孕妇,根据其孕前体质量指数(BMI)和 GWG 与 2020 年美国医学研究所(IOM)建议的关系,将其分为三组。收集围产期结局、妊娠期间尿失禁(UI)、性功能变化以及分娩住院医疗费用等数据。采用单因素和多因素逻辑回归模型来探讨这些关联。

结果

仅有 42.1%的女性符合 2020 年 IOM 指南。在调整了潜在混杂因素后,超重 GWG 的女性发生不良妊娠结局的风险增加,包括胎儿头围大和巨大儿,而低体重 GWG 的女性比正常 GWG 的女性更有可能早产低体重儿。仅有 16.8%的女性报告在妊娠期间有性行为。三组 GWG 组之间的性行为和满意度或 QoL 无显著差异。超重 GWG 的女性分娩费用高于正常 GWG 的女性。尽管超重 GWG 的分娩费用较高,但随着孕前 BMI 的增加,费用高于中位数的女性比例也有所增加。

结论

本研究结果表明,不适当的 GWG 与不良围产期结局风险增加以及分娩医疗费用增加相关。建议医疗保健提供者在整个孕期根据 2020 年 IOM 建议,为女性提供 GWG 管理指导。

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