Faculty of Medicine, Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
J Obstet Gynaecol Res. 2024 Mar;50(3):403-423. doi: 10.1111/jog.15863. Epub 2024 Jan 1.
This study aimed to determine the weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy body mass index (BMI) and make recommendations for optimal weight gain in Japan.
The Japan Society of Obstetrics and Gynecology perinatal database for 2015-2017 was used. From the 719 723 deliveries included in this database, parturients with underlying diseases or missing data were excluded, and 419 114 deliveries were analyzed. A questionnaire survey was also conducted to weigh each perinatal adverse event. For each of the nine outcomes, a restricted cubic spline model was made to estimate the association between the "expected gestational weight gain at 40 weeks" and the outcome risk.
Since the classes of medical facilities were generally the same, weights were assigned according to the mean of the questionnaires rather than by the class of the facility. For each pre-pregnancy BMI, the weight gains during pregnancy that minimized the predicted probability of various adverse perinatal events were 12-15, 10-13, 7-10, and upper limit of 5 kg for the underweight, normal-weight, obese 1, and obese ≥2 groups, respectively.
The weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy BMI was established.
本研究旨在根据孕前体重指数（BMI）确定怀孕期间体重增加多少可最小化各种围产期不良事件的预测概率，并为日本提供最佳的体重增加建议。
使用 2015-2017 年日本妇产科协会围产数据库。排除该数据库中存在基础疾病或数据缺失的产妇，共分析了 719723 例分娩。还进行了问卷调查以衡量每种围产期不良事件的权重。对于九个结果中的每一个，都制作了受限立方样条模型来估计“40 周时预期的体重增加”与结果风险之间的关联。
由于医疗设施的类别通常相同，因此根据问卷的平均值而不是设施的类别来分配权重。对于每个孕前 BMI，最小化各种不良围产期事件预测概率的孕期体重增加分别为：消瘦组 12-15kg、正常体重组 10-13kg、超重 1 组 7-10kg、超重≥2 组上限为 5kg。
根据孕前 BMI 确定了可最小化各种围产期不良事件预测概率的孕期体重增加量。
