Hickey C A, Cliver S P, McNeal S F, Hoffman H J, Goldenberg R L
Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, USA.
Obstet Gynecol. 1995 Jun;85(6):909-14. doi: 10.1016/0029-7844(95)00067-2.
To examine the relationship between prenatal weight gain and spontaneous preterm delivery, using the Institute of Medicine (IOM) guidelines.
Nonobese low-income black (677 subjects) and white (338) women were grouped by ethnicity and prepregnancy body mass index (BMI) as low (less than 19.8) or normal (19.8-26.0). The relationship of total gain (first trimester) and weekly rate of gain (second and third trimester) to spontaneous preterm delivery was determined while controlling for sociodemographic and reproductive variables as well as for time between last weight observation and delivery.
For all women combined, the mean (+/- standard deviation) weight gain during the first trimester was 2.48 +/- 3.36 kg, and the mean rate of gain during the second and third trimesters was 0.49 +/- 0.21 and 0.45 +/- 0.28 kg/week, respectively. Low first- or second-trimester weight gain was not associated with increased adjusted odds ratios (OR) for spontaneous preterm delivery. Third-trimester rates of gain below the lower limit of the IOM-recommended range (less than 0.38 kg/week with low BMI, less than 0.37 kg/week with normal BMI) were associated with increased preterm delivery among all women (OR 2.46, 95% confidence interval [CI] 1.53-3.92), all black women (OR 1.98, 95% CI 1.16-3.41), and all white women (OR 4.05, 95% CI 1.41-11.66).
These observations suggest that a low third-trimester rate of weight gain, defined using IOM guidelines, is associated with an increased risk of spontaneous preterm delivery among nonobese black and white women.
采用美国医学研究所（IOM）指南，研究孕期体重增加与自然早产之间的关系。
非肥胖低收入黑人（677名受试者）和白人（338名）女性按种族和孕前体重指数（BMI）分为低体重组（低于19.8）或正常体重组（19.8 - 26.0）。在控制社会人口统计学和生殖变量以及末次体重观察与分娩之间的时间的同时，确定总增重（孕早期）和每周增重率（孕中期和孕晚期）与自然早产的关系。
所有女性的综合数据显示，孕早期平均（±标准差）体重增加2.48±3.36千克，孕中期和孕晚期的平均增重率分别为0.49±0.21和0.45±0.28千克/周。孕早期或孕中期体重增加较低与自然早产的调整优势比（OR）增加无关。孕晚期增重率低于IOM推荐范围的下限（低BMI者低于0.38千克/周，正常BMI者低于0.37千克/周）与所有女性（OR 2.46，95%置信区间[CI] 1.53 - 3.92）、所有黑人女性（OR 1.98，95% CI 1.16 - 3.41）和所有白人女性（OR 4.05，95% CI 1.41 - 11.66）的早产增加有关。
这些观察结果表明，根据IOM指南定义的孕晚期低增重率与非肥胖黑人和白人女性自然早产风险增加有关。
