Teles T P, Rodrigues T, Barros H
Serviço de Ginecologia e Obstetrícia, H. Vila Nova de Famalição, Faculdade de Medicina do Porto.
Acta Med Port. 1994 Dec;7(12):669-75.
The aim of this study was to evaluate the association between maternal nutritional factors and intrauterine growth retardation (IUGR). We studied 1233 mothers who delivered single term newborns: 144 IUGR-birth weight less than one 10th percentile for sex and gestational age and 1119 controls-birth weight between the 10th and the 90th percentile. Maternal anthropometric factors (height, weight before and at the end of pregnancy, total and weekly weight gain and body mass index) were stratified according to quartiles of distribution in the studied population. Unconditional multiple logistic regression was used to estimate odds ratios (OR), adjusting each anthropometric parameter for non nutritional confounders (parity, smoking, gestational illness and history of low birth weight) and the effect of prepregnancy weight or weight gain. Mothers of IUGR cases showed significantly lower mean values of pre and end pregnancy weight, body mass index and total or weekly weight gain. Compared to the reference category (first quartile) women in upper quartiles of total or weekly weight gain, or end pregnancy weight showed significantly lower risks. For a total weight gain of 10-11 kg an OR of 0.43 was found, and that for a weekly gain of 238-297 g was 0.35. An end pregnancy weight between 63 and 68 kg had an OR or 0.45. However, compared to the second no evident benefit was found for the third or fourth quartiles of weight gains, where an increased risk of macrosomia can be anticipated. These results indicate that attitudes during prenatal care towards adequate weight gains may further reduce the risk of IUGR and the associated morbidity and mortality.
本研究的目的是评估母亲营养因素与宫内生长受限（IUGR）之间的关联。我们研究了1233名分娩单胎足月儿的母亲：144例IUGR患儿——出生体重低于同性别、同孕周第10百分位数；1119例对照——出生体重在第10至第90百分位数之间。根据研究人群中分布的四分位数，对母亲的人体测量学因素（身高、孕前和孕末期体重、总体重和每周体重增加量以及体重指数）进行分层。采用无条件多因素logistic回归来估计比值比（OR），针对非营养性混杂因素（产次、吸烟、孕期疾病和低出生体重史）以及孕前体重或体重增加的影响对每个人体测量参数进行校正。IUGR患儿的母亲孕前和孕末期体重、体重指数以及总体重或每周体重增加量的平均值显著较低。与参考类别（第一四分位数）相比，总体重或每周体重增加量或孕末期体重处于较高四分位数的女性风险显著较低。总体重增加10 - 11 kg时，OR为0.43；每周体重增加238 - 297 g时，OR为0.35。孕末期体重在63至68 kg之间，OR为0.45。然而，与第二四分位数相比，第三或第四四分位数的体重增加并未显示出明显益处，在此情况下可能预期巨大儿风险增加。这些结果表明，产前护理中对适当体重增加的态度可能会进一步降低IUGR及其相关发病率和死亡率的风险。
