Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Pennington Biomedical Research Center, Baton Rouge, Louisiana.
JAMA Netw Open. 2023 Aug 1;6(8):e2331277. doi: 10.1001/jamanetworkopen.2023.31277.
Average gestational weight gain (GWG) increased during the COVID-19 pandemic, but it is not known whether this trend has continued.
To examine patterns of GWG during the COVID-19 pandemic by delivery and conception timing through the second year of the pandemic.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study is a retrospective review of birth certificate and delivery records from 2019 to 2022. Electronic health records were from the largest delivery hospital in Louisiana. Participants included all individuals giving birth from March 2019 to March 2022. Data analysis was performed from October 2022 to July 2023.
Delivery date (cross-sectionally) and conception before the pandemic (March 2019 to March 2020) and during the peak pandemic (March 2020 to March 2021) and late pandemic (March 2021 to March 2022).
The primary outcome was GWG (total GWG and adherence to the 2009 Institute of Medicine recommendations) analyzed using linear and log-linear regression with control for covariates.
Among 23 012 total deliveries (8763 Black individuals [38.1%]; 11 774 White individuals [51.2%]; mean [SD] maternal age, 28.9 [5.6] years), 3182 individuals (42.0%) exceeded the recommended weight gain in the year proceeding the pandemic, 3400 (45.4%) exceeded recommendations during the peak pandemic, and 3273 (44.0%) exceeded recommendations in the late pandemic. Compared with those who delivered before the pandemic (reference), participants had higher total GWG if they delivered peak or late pandemic (adjusted β [SE], 0.38 [0.12] kg vs 0.19 [0.12] kg; P = .007). When cohorts were defined by conception date, participants who conceived before the pandemic but delivered after the pandemic started had higher GWG compared with those whose entire pregnancy occurred before the pandemic (adjusted β [SE], 0.51 [0.16] kg). GWG was lower in the pregnancies conceived after the pandemic started and the late pandemic (adjusted β [SE], 0.29 [0.12] kg vs 0.003 [0.14] kg; P = .003) but these participants began pregnancy at a slightly higher weight. Examining mean GWG month by month suggested a small decrease for March 2020, followed by increased mean GWG for the following year. Individuals with 2 pregnancies (1289 individuals) were less likely to gain weight above the recommended guidelines compared with their prepandemic pregnancy, but this association was attenuated after adjustment.
In this cohort, individuals with critical time points of their pregnancy during the COVID-19 pandemic gained more weight compared with the previous year. The increased GWG leveled off as the pandemic progressed but individuals were slightly heavier beginning pregnancy.
在 COVID-19 大流行期间，平均妊娠增重 (GWG) 增加，但尚不清楚这一趋势是否持续。
通过大流行第二年的分娩和受孕时间，检查 COVID-19 大流行期间 GWG 的模式。
设计、地点和参与者：这是一项对 2019 年至 2022 年出生证明和分娩记录的回顾性队列研究。电子健康记录来自路易斯安那州最大的分娩医院。参与者包括所有在 2019 年 3 月至 2022 年 3 月期间分娩的个体。数据分析于 2022 年 10 月至 2023 年 7 月进行。
分娩日期（横截面）和大流行前（2019 年 3 月至 2020 年 3 月）和大流行高峰期（2020 年 3 月至 2021 年 3 月）以及大流行后期（2021 年 3 月至 2022 年 3 月）受孕。
主要结局是 GWG（总 GWG 和遵守 2009 年医学研究所建议），使用线性和对数线性回归进行分析，并控制了协变量。
在 23012 例总分娩中（8763 名黑人个体[38.1%]；11774 名白人个体[51.2%]；母亲平均年龄[标准差]，28.9[5.6]岁），3182 名个体（42.0%）在大流行前一年体重增加超过建议水平，3400 名个体（45.4%）在高峰期超过建议水平，3273 名个体（44.0%）在大流行后期超过建议水平。与大流行前分娩的个体（参考）相比，在高峰期或大流行后期分娩的参与者总 GWG 更高（调整后β[SE]，0.38[0.12]kg vs 0.19[0.12]kg；P=0.007）。当按受孕日期定义队列时，与整个孕期都在大流行前的个体相比，在大流行开始后受孕但分娩的个体 GWG 更高（调整后β[SE]，0.51[0.16]kg）。在大流行后受孕和大流行后期受孕的孕妇 GWG 较低（调整后β[SE]，0.29[0.12]kg vs 0.003[0.14]kg；P=0.003），但这些参与者开始怀孕时体重略高。逐月检查平均 GWG 表明，2020 年 3 月略有下降，随后下一年的平均 GWG 增加。与大流行前的怀孕相比，有 2 次怀孕（1289 人）的个体体重增加超过建议标准的可能性较小，但这种关联在调整后减弱。
在这项队列研究中，妊娠关键时间点处于 COVID-19 大流行期间的个体与前一年相比体重增加。随着大流行的发展，GWG 水平趋于平稳，但个体开始怀孕时体重略高。
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