School of General Practice and Continuing Education, Capital Medical University, No. 10 You An Men Wai Xi Tou Tiao, Beijing, 100069, China.
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, 100026, China.
BMC Pregnancy Childbirth. 2024 May 31;24(1):399. doi: 10.1186/s12884-024-06592-y.
The purpose was to explore the optimal proportion of GWG in Chinese singleton pregnant women according to Chinese specific body mass index (BMI) categories.
A retrospective cohort study with 16,977 singleton pregnant women was conducted. Among the including subjects, 2/3 of which were randomly imported into the training set for calculating the optimal GWG ranges using the percentile method, the Odd Ratio (OR) method, and the combined risk curve method. And another third of the subjects were used to evaluate the GWG ranges obtained. The detection rate of adverse outcomes of pregnant women was used to evaluate the applicability of GWG obtained. The range corresponding to the lowest detection rate is the recommended GWG range in this study.
According to the percentile method, the suitable GWG of pregnant women with underweight, normal weight, overweight or obesity before pregnancy were 12.0 ∼ 17.5 kg, 11.0 ∼ 17.0 kg, and 9.0 ∼ 15.5 kg, respectively. According to the OR method, the suitable GWG range were 11 ∼ 18 kg, 7 ∼ 11 kg, and 6 ∼ 8 kg, respectively. According to the combined risk curve method, the suitable GWG range were 11.2 ∼ 17.2 kg, 3.6 ∼ 11.5 kg, and - 5.2 ∼ 7.0 kg, respectively. When the GWG for different BMI categories were 11 ∼ 18 kg, 7 ∼ 11 kg, and 6 ∼ 8 kg, the pregnant women have the lowest detection rate of adverse maternal and infant outcomes.
The recommended GWG based on this study for underweight, normal, overweight or obese pregnant women were 11 ∼ 18 kg, 7 ∼ 11 kg, and 6 ∼ 8 kg, respectively.
目的是根据中国特有的体重指数（BMI）类别，探讨中国单胎孕妇 GWG 的最佳比例。
对 16977 例单胎孕妇进行回顾性队列研究。其中 2/3随机导入训练集，采用百分位数法、比值比（OR）法和联合风险曲线法计算最佳 GWG 范围。另外 1/3的受试者用于评估获得的 GWG 范围。检测孕妇不良结局的发生率来评估 GWG 的适用性。获得的 GWG 范围对应的检测率最低，即为本研究推荐的 GWG 范围。
根据百分位数法，孕前体重不足、正常体重、超重或肥胖的孕妇适宜 GWG 分别为 12.0∼17.5kg、11.0∼17.0kg、9.0∼15.5kg。根据 OR 法，适宜 GWG 范围分别为 11∼18kg、7∼11kg、6∼8kg。根据联合风险曲线法，适宜 GWG 范围分别为 11.2∼17.2kg、3.6∼11.5kg、-5.2∼7.0kg。当不同 BMI 类别孕妇的 GWG 为 11∼18kg、7∼11kg、6∼8kg 时，母婴不良结局的检测率最低。
本研究推荐的孕前体重不足、正常、超重或肥胖孕妇 GWG 分别为 11∼18kg、7∼11kg、6∼8kg。
