Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Division of Maternal-Fetal Medicine, South Shore University Hospital, 376 E Main St, Suite 202, Bay Shore, NY, 11706, USA.
Arch Gynecol Obstet. 2024 Apr;309(4):1295-1303. doi: 10.1007/s00404-023-07000-0. Epub 2023 Mar 17.
Excessive gestational weight gain (EGWG) is associated with adverse maternal and offspring outcomes but efforts to identify women at high risk for EGWG have been limited. The objective of this study is to identify socioeconomic and clinical factors associated with EGWG.
This retrospective cohort included pregnant patients who delivered live, term, singleton newborns between January 2018 and February 2020 at seven hospitals within a large health system in New York. Patients were stratified by pre-pregnancy body mass index and then classified based on whether they exceeded the Institute of Medicine guidelines for gestational weight gain (GWG) and whether they gained more than 50 pounds in pregnancy.
A total of 44,872 subjects were included for analysis: 48% had EGWG and 17% had GWG exceeding 50 pounds. Patients with EGWG were more likely to be Black race, English speakers, overweight or obese pre-pregnancy, and have a mood disorder diagnosis. Patients who were underweight, multiparous, and those with gestational diabetes were less likely to have EGWG.
Sociodemographic and clinical findings associated with GWG > 50 pounds were similar but only overweight and not obese patients were at increased risk. Patients at risk for EGWG may benefit from early nutrition counseling and education on lifestyle changes.
妊娠体重过度增加（EGWG）与母婴不良结局相关，但识别易发生 EGWG 的高危女性的努力有限。本研究旨在确定与 EGWG 相关的社会经济和临床因素。
本回顾性队列纳入了 2018 年 1 月至 2020 年 2 月期间在纽约一家大型医疗系统的七家医院分娩活产、足月、单胎新生儿的孕妇。根据妊娠前体重指数对患者进行分层，然后根据是否超过医学研究所妊娠体重增加（GWG）指南以及是否在妊娠期间增重超过 50 磅进行分类。
共纳入 44872 例患者进行分析：48%发生 EGWG，17%的患者 GWG 超过 50 磅。发生 EGWG 的患者更可能为黑种人、英语为母语、妊娠前超重或肥胖，且有情绪障碍诊断。体重过轻、多产妇以及患有妊娠期糖尿病的患者不太可能发生 EGWG。
与 GWG>50 磅相关的社会人口学和临床特征相似，但仅超重而非肥胖患者风险增加。有发生 EGWG 风险的患者可能受益于早期营养咨询和生活方式改变的教育。
