Academic Master's Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Bloco J2, sala 26, Cidade Universitária, Rio de Janeiro, RJ, 21941-590, Brazil; Maternity School, Federal University of Rio de Janeiro. Rua das Laranjeiras, 180, Rio de Janeiro, RJ, 22240-003, Brazil.
Academic Master's Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Bloco J2, sala 26, Cidade Universitária, Rio de Janeiro, RJ, 21941-590, Brazil; Maternity School, Federal University of Rio de Janeiro. Rua das Laranjeiras, 180, Rio de Janeiro, RJ, 22240-003, Brazil; Professional Master's Program in Clinical Nutrition, INJC, UFRJ, Brazil.
Clin Nutr ESPEN. 2022 Aug;50:207-211. doi: 10.1016/j.clnesp.2022.05.016. Epub 2022 May 27.
To evaluate the association of gestational weight gain and adverse maternal and perinatal outcomes among Brazilian women with gestational diabetes mellitus (GDM).
Cross-sectional study conducted in women with GDM, and their newborns, who attended a public maternity hospital. The Institute of Medicine criteria were adopted to assess adequacy of gestational weight gain (GWG). Cesarean delivery, maternal hypertensive disorders of pregnancy (HDP), premature birth, macrosomia, and birth weight adequacy for gestational age were analyzed as outcomes. Simple and multiple logistic regression models were tested to assess the effect of adequacy of GWG on maternal and newborn outcomes.
Among the 545 women studied, 64.2% (n = 344) had inadequate weight gain: 27.2% (n = 146) insufficient and 37% (n = 198) excessive. Women with insufficient GWG were more likely to have a preterm birth (OR 2.57; 95% CI: 1.06-6.19), while those with excessive GWG had a greater chance of HDP (OR 2.62; 95% CI: 1.54-4.45) and large for gestational age newborn (OR 1.88; 95% CI: 1.08-3.29), compared with those with adequate weight gain.
Inadequate gestational weight gain was frequent in women with GDM, especially in pregnant women with overweight and obesity, and is associated with unfavorable outcomes.
评估巴西患有妊娠期糖尿病(GDM)的女性的妊娠体重增加与不良母婴围产结局的相关性。
本横断面研究纳入了在一家公立妇产医院就诊的 GDM 女性及其新生儿。采用美国医学研究院的标准来评估妊娠体重增加(GWG)的充足性。将剖宫产、妊娠高血压疾病(HDP)、早产、巨大儿和出生体重与胎龄的适宜性作为结局进行分析。采用简单和多因素逻辑回归模型来评估 GWG 充足性对母婴结局的影响。
在 545 名研究对象中,64.2%(n=344)的女性体重增加不足:27.2%(n=146)为不足,37%(n=198)为过多。与 GWG 充足的女性相比,GWG 不足的女性更有可能早产(OR 2.57;95%CI:1.06-6.19),而 GWG 过多的女性发生 HDP 的几率更高(OR 2.62;95%CI:1.54-4.45),且其新生儿为巨大儿的几率也更高(OR 1.88;95%CI:1.08-3.29)。
患有 GDM 的女性中,妊娠体重增加不足的情况较为常见,尤其是超重和肥胖的孕妇,且与不良结局相关。