Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, Fukushima, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan.
J Obstet Gynaecol Res. 2022 Nov;48(11):2766-2773. doi: 10.1111/jog.15372. Epub 2022 Jul 27.
To examine the effect of weight gain during pregnancy on hypertension disorders of pregnancy among women with a prepregnancy body mass index ≥30.0 kg/m .
This retrospective cohort study included 257 Japanese women (116 primipara; 141 multipara) with singleton pregnancies with a prepregnancy body mass index ≥ 30.0 kg/m , who gave birth during 2013 to 2020 at Ohta Nishinouchi Hospital. Multiple logistic regression analyses were performed to identify the effect of gestational weight gain on early-onset (<34 weeks), late-onset (≥34 weeks), and overall hypertension disorders of pregnancy.
The prevalence of hypertension disorders of pregnancy in primiparas and multiparas was 28.4% and 11.3%, respectively. By multiple logistic regression analysis, gestational weight gain during pregnancy increased the risk of early-onset (adjusted odds ratio: 1.20, 95% confidence interval: 1.03-1.39, p < 0.05) and overall hypertension disorders of pregnancy (adjusted odds ratio: 1.12, 95% confidence interval: 1.03-1.22, p < 0.05) among primiparas. Based on receiver operating characteristic curve analyses for early-onset (area under the curve 0.67, 95% confidence interval: 0.56-0.78; p < 0.05) and overall hypertension disorders of pregnancy (area under the curve 0.76, 95% confidence interval: 0.61-0.91; p < 0.05) among primiparas, we determined the cut-off weight gain during pregnancy for early-onset and overall hypertension disorders of pregnancy as 3.85 kg, with sensitivity/specificity of 0.76/0.59 and 0.91/0.53, respectively.
We recommend that the optimal gestational weight gain for reducing HDP be under 3.85 kg. This information may facilitate personalized pre-conception counseling among women with obesity.
探讨孕前体重指数（BMI）≥30.0kg/m²的孕妇孕期体重增加对妊娠高血压疾病的影响。
本回顾性队列研究纳入了 2013 年至 2020 年期间在大戸西野医院分娩的 257 名 BMI≥30.0kg/m²的单胎妊娠初产妇（116 名）和经产妇（141 名）。采用多因素逻辑回归分析探讨孕期体重增加对早发型（<34 周）、晚发型（≥34 周）和总妊娠高血压疾病的影响。
初产妇和经产妇妊娠高血压疾病的患病率分别为 28.4%和 11.3%。多因素逻辑回归分析显示，孕期体重增加使初产妇发生早发型（调整优势比：1.20，95%置信区间：1.03-1.39，p<0.05）和总妊娠高血压疾病（调整优势比：1.12，95%置信区间：1.03-1.22，p<0.05）的风险增加。基于初产妇早发型（曲线下面积 0.67，95%置信区间：0.56-0.78；p<0.05）和总妊娠高血压疾病（曲线下面积 0.76，95%置信区间：0.61-0.91；p<0.05）的受试者工作特征曲线分析，我们确定了早发型和总妊娠高血压疾病孕期体重增加的最佳切点为 3.85kg，其敏感性/特异性分别为 0.76/0.59 和 0.91/0.53。
我们建议，降低妊娠高血压疾病风险的孕期最佳增重应小于 3.85kg。这些信息可能有助于肥胖女性进行个性化的孕前咨询。
