Mosquera Paola Soledad, Malta Maíra Barreto, de Araújo Damasceno Ana Alice, Neves Paulo Augusto Ribeiro, Matijasevich Alicia, Cardoso Marly Augusto
Department of Nutrition, School of Public Health, Universidade de São Paulo, Av Dr Arnaldo 715, São Paulo, 01246-904, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Matern Child Health J. 2022 Oct;26(10):2030-2039. doi: 10.1007/s10995-022-03480-9. Epub 2022 Jul 31.
To investigate the association between gestational weight gain (GWG) and perinatal outcomes in pregnant Amazonian women.
Data from 1305 mother-child pairs from the MINA-Brazil population-based birth cohort study were used. GWG was classified according to two methods, the Institute of Medicine (IOM) guidelines and INTERGROWTH-21st standards. Poisson and linear regression analyses were conducted to evaluate associations with perinatal outcomes.
Following IOM guidelines (n = 1305), the rates of insufficient and excessive GWG were found to be similar (32%). Excessive GWG was associated with higher new-born birthweight (BW) z-scores; increased risks of macrosomia, large for gestational age (LGA), and caesarean delivery; and lower risks of low birthweight (LBW) and being small for gestational age (SGA). Insufficient GWG was associated with lower new-born BW z-scores. Among women with normal pre-pregnancy body mass indices (BMIs, n = 658), inappropriate GWG was high following both methods (IOM: 41.2% insufficient, 24.8% excessive; INTERGROWTH-21st: 25.2% below - 1 z-score, 16.9% above 1 z-score). Both methods also indicated that new-borns of women with excessive GWG had higher BW z-scores and increased risk of macrosomia and LGA. Women with GWG below the INTERGROWTH-21st standards were more likely to deliver an infant SGA and with lower BW z-scores.
Inappropriate GWG remains a health concern irrespective of the method used to classify weight gain. GWG above the recommendations of both methods and below the INTERGROWTH-21st standard was associated with adverse perinatal outcomes. Therefore, INTERGROWTH-21st standards seem to be a better fit for healthy women in this population.
探讨亚马逊地区孕妇孕期体重增加（GWG）与围产期结局之间的关联。
使用来自巴西基于人群的MINA出生队列研究的1305对母婴数据。GWG根据两种方法进行分类，即美国医学研究所（IOM）指南和INTERGROWTH-21标准。进行泊松回归和线性回归分析以评估与围产期结局的关联。
按照IOM指南（n = 1305），GWG不足和过量的发生率相似（32%）。GWG过量与新生儿出生体重（BW）z评分较高相关；巨大儿、大于胎龄儿（LGA）和剖宫产风险增加；低出生体重（LBW）和小于胎龄儿（SGA）风险降低。GWG不足与新生儿BW z评分较低相关。在孕前体重指数（BMI）正常的女性中（n = 658），两种方法下不适当的GWG发生率都很高（IOM：不足41.2%，过量24.8%；INTERGROWTH-21：低于-1 z评分25.2%，高于1 z评分16.9%）。两种方法还表明，GWG过量的女性所生新生儿的BW z评分较高，巨大儿和LGA风险增加。GWG低于INTERGROWTH-21标准的女性更有可能分娩SGA婴儿且BW z评分较低。
无论采用何种方法对体重增加进行分类，不适当的GWG仍然是一个健康问题。两种方法建议值以上且低于INTERGROWTH-21标准的GWG与不良围产期结局相关。因此，INTERGROWTH-21标准似乎更适合该人群中的健康女性。
