National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China.
Matern Child Nutr. 2024 Jul;20(3):e13578. doi: 10.1111/mcn.13578. Epub 2024 Apr 4.
Few studies have reported the timing and amount of gestational weight gain (GWG) to prevent large-for-gestational-age (LGA) or small-for-gestational-age (SGA). This study aimed to evaluate the association of GWG velocity in each trimester with LGA or SGA based on data from the Taicang and Wuqiang cohort study (TAWS, n = 2008). We used a linear mixed model to evaluate the association of trimester-specific GWG velocity with birthweight categories and stratified by prepregnancy body mass index category and parity. For normal-weight pregnant women, mothers with LGA births had higher GWG velocities than mothers with appropriate-for-gestational-age (AGA) births in the first trimester (0.108 vs. 0.031 kg/week, p < 0.01), second trimester (0.755 vs. 0.631 kg/week, p < 0.01) and third trimester (0.664 vs. 0.594 kg/week, p < 0.01); in contrast, mothers with SGA births had lower GWG velocities than mothers with AGA births in the second trimester (0.528 vs. 0.631 kg/week, p < 0.01) and third trimester (0.541 vs. 0.594 kg/week, p < 0.01). For normal-weight pregnant women with AGA births, multiparous women had lower GWG velocities than primiparous women in the second (0.602 vs. 0.643 kg/week, p < 0.01) and third trimesters (0.553 vs. 0.606 kg/week, p < 0.01). Therefore, for normal-weight women, LGA prevention would begin in early pregnancy and continue until delivery and the second and third trimesters may be critical periods for preventing SGA; in addition, among normal-weight pregnant women with AGA births, multiparous women tend to have lower weight gain velocities than primiparous women.
很少有研究报告过妊娠体重增加（GWG）的时间和量，以预防巨大儿（LGA）或小于胎龄儿（SGA）。本研究旨在根据太仓和武强队列研究（TAWS，n=2008）的数据，评估每个孕期 GWG 速度与 LGA 或 SGA 的关系。我们使用线性混合模型来评估孕期特定 GWG 速度与出生体重分类的关系，并按孕前体重指数类别和产次进行分层。对于正常体重的孕妇，LGA 出生的母亲在孕早期（0.108 与 0.031kg/周，p<0.01）、孕中期（0.755 与 0.631kg/周，p<0.01）和孕晚期（0.664 与 0.594kg/周，p<0.01）的 GWG 速度高于 AGA 出生的母亲；相反，SGA 出生的母亲在孕中期（0.528 与 0.631kg/周，p<0.01）和孕晚期（0.541 与 0.594kg/周，p<0.01）的 GWG 速度低于 AGA 出生的母亲。对于正常体重且 AGA 出生的孕妇，多产妇在孕中期（0.602 与 0.643kg/周，p<0.01）和孕晚期（0.553 与 0.606kg/周，p<0.01）的 GWG 速度低于初产妇。因此，对于正常体重的女性，LGA 的预防应从孕早期开始，并持续到分娩以及孕中期和孕晚期可能是预防 SGA 的关键时期；此外，对于正常体重且 AGA 出生的孕妇，多产妇的体重增加速度往往低于初产妇。
