Jin Toki, Kyozuka Hyo, Fukuda Toma, Fujimori Mimori, Murata Tsuyoshi, Nomura Shinji, Suzuki Daisuke, Nomura Yasuhisa, Imamura Takashi, Yasuda Shun, Yamaguchi Akiko, Fujimori Keiya
Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, Koriyama City, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Japan.
J Obstet Gynaecol Res. 2021 Dec;47(12):4241-4249. doi: 10.1111/jog.15058. Epub 2021 Oct 15.
The effect of gestational weight gain on placental weight has not been elucidated. We aimed to examine the effect of body weight gain during pregnancy on the Japanese standardized z-score of placental weight, based on the pre-pregnancy body mass index.
This retrospective cohort study included Japanese women with singleton pregnancies who gave birth during 2013-2019 at Ohta Nishinouchi Hospital. Participants (n = 3610) were categorized by their pre-pregnancy body mass index: G1 (<18.5 kg/m ), G2 (18.5 to <20.0 kg/m ), G3 (20.0 to <23.0 kg/m ), G4 (23.0 to <25.0 kg/m ), and G5 (≥25.0 kg/m ). Multiple linear regression analysis was used to identify associations between insufficient or excessive gestational weight gain in each body mass index category and z-score of placental weight, with adjustments for maternal age, assisted reproductive technology, and maternal pre-pregnancy conditions, such as hypertension, diabetes mellitus, myoma uteri, and uterine anomalies.
Among the 3610 women assessed, 479, 692, 1292, 435, and 711 were in G1-G5, respectively. In G1, G3, and G4, excessive weight gain increased the placental weight z-score ([B: 0.50, 95% confidence interval [CI]: 0.23-0.76], [B: 0.19, 95% CI: 0.19-0.33], and [B: 0.18, 95% CI: 0.10-0.26]). Insufficient weight gain decreased the placental weight z-score in G3 (B: -0.19, 95% CI: -0.33 to -0.06) and G4 (B: -0.21, 95% CI: -0.29 to -0.13) women.
The effect of weight gain during pregnancy on placental size varies by pre-pregnancy body mass index. This result may guide personalized pre-conception counseling to improve the outcomes of offspring.
妊娠期体重增加对胎盘重量的影响尚未阐明。我们旨在根据孕前体重指数，研究孕期体重增加对胎盘重量日本标准化z评分的影响。
这项回顾性队列研究纳入了2013年至2019年在太田西之内医院分娩的单胎妊娠日本女性。参与者（n = 3610）根据孕前体重指数进行分类：G1（<18.5kg/m²）、G2（18.5至<20.0kg/m²）、G3（20.0至<23.0kg/m²）、G4（23.0至<25.0kg/m²）和G5（≥25.0kg/m²）。采用多元线性回归分析，确定每个体重指数类别中妊娠期体重增加不足或过多与胎盘重量z评分之间的关联，并对产妇年龄、辅助生殖技术以及产妇孕前状况（如高血压、糖尿病、子宫肌瘤和子宫异常）进行调整。
在评估的3610名女性中，分别有479、692、1292、435和711名女性属于G1 - G5组。在G1、G3和G4组中，体重增加过多会增加胎盘重量z评分（[B：0.50，95%置信区间[CI]：0.23 - 0.76]，[B：0.19，95%CI：0.19 - 0.33]，以及[B：0.18，95%CI：0.10 - 0.26]）。体重增加不足会降低G3组（B： - 0.19，95%CI： - 0.33至 - 0.06）和G4组（B： - 0.21，95%CI： - 0.29至 - 0.13）女性的胎盘重量z评分。
孕期体重增加对胎盘大小的影响因孕前体重指数而异。这一结果可能为个性化的孕前咨询提供指导，以改善后代结局。
