Hickey C A, Cliver S P, Goldenberg R L, Kohatsu J, Hoffman H J
Division of Maternal and Child Health, School of Public Health, University of Alabama, Birmingham.
Obstet Gynecol. 1993 Apr;81(4):529-35.
To examine the association of prenatal weight gain below, within, and above the Institute of Medicine guidelines with birth weight and fetal growth restriction (FGR) among low-income, high-risk black and white women.
Eight hundred three black and 365 white women were grouped by pregravid body mass index (BMI): low (below 19.8), normal (19.8-26), high (above 26-29), and very high (above 29). The impact of maternal weight gain on birth weight and race-specific FGR was determined while controlling for sociodemographic and reproductive variables and for time between last weight observation and delivery.
One-third of both black and white women failed to achieve the Institute of Medicine minimum recommended gain for pregravid BMI. More women with low BMI gained less than the recommended weight as compared with those having normal, high, or very high BMI. Nonobese black women (BMI 29 or below) delivered fewer infants with FGR as weight gain increased from below the recommended range (17.9% FGR) to within (10.3% FGR) or above (3.8% FGR) the range; corresponding data for nonobese white women were 20.9, 19.1, and 10.5% FGR, respectively. Obese black women (BMI above 29) also delivered fewer infants with FGR (4.2%) when they exceeded the minimum gain (6 kg) than did white women (11.8%). When analysis of covariance was used to adjust mean birth weight, black women in each pregravid BMI category delivered increasingly larger infants (P < or = .01 for each category) as they met or exceeded the guidelines; among white women this trend was attenuated.
These observations support the Institute of Medicine suggestion that black women strive for prenatal weight gain at the upper end of the recommended range for pregravid BMI.
研究低收入高危黑人和白人女性孕期体重增加低于、处于或高于医学研究所指南范围与出生体重及胎儿生长受限（FGR）之间的关联。
803名黑人女性和365名白人女性根据孕前体重指数（BMI）分组：低体重（低于19.8）、正常体重（19.8 - 26）、高体重（高于26 - 29）和极高体重（高于29）。在控制社会人口统计学和生殖变量以及上次体重观察与分娩之间的时间的同时，确定孕妇体重增加对出生体重和种族特异性FGR的影响。
黑人和白人女性中均有三分之一未达到医学研究所针对孕前BMI的最低推荐增加量。与BMI正常、高或极高的女性相比，更多低BMI女性的体重增加低于推荐量。随着体重增加从低于推荐范围（FGR为17.9%）增加到处于（FGR为10.3%）或高于（FGR为3.8%）该范围，非肥胖黑人女性（BMI为29或更低）分娩的FGR婴儿数量减少；非肥胖白人女性的相应数据分别为20.9%、19.1%和10.5%。肥胖黑人女性（BMI高于29）在超过最低增加量（6千克）时，分娩的FGR婴儿也比白人女性（11.8%）少（4.2%）。当使用协方差分析调整平均出生体重时，每个孕前BMI类别的黑人女性在达到或超过指南时分娩的婴儿越来越大（每个类别P≤0.01）；在白人女性中，这种趋势减弱。
这些观察结果支持医学研究所的建议，即黑人女性应争取在孕前BMI推荐范围的上限进行孕期体重增加。
