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. 1996 Oct;88(4 Pt 1):490-6. doi: 10.1016/0029-7844(96)00262-1.
To examine the association between prenatal weight gain patterns and birth weight, using Institute of Medicine (IOM) guidelines.
Data from a prospective follow-up study of risk factors for fetal growth restriction were used to examine the impact of low weight gain on mean birth weight. A total of 415 nonobese (body mass index [BMI] less than 26) black (n = 275) and white (n = 140) women who delivered at term were included in this analysis. Linear regression analysis was used to examine the impact of low first-trimester gain (less than 2.3 kg with low BMI [less than 19.8]; less than 1.6 kg with normal BMI [19.8-26.0]) and low second- and third-trimester rates of gain (less than 0.38 kg/week with low BMI; less than 0.37 kg/week with normal BMI) on mean birth weight while controlling for selected sociodemographic and reproductive variables.
Patterns with low gain in the first and second or in the second and third trimesters were associated with significant decreases in mean birth weight, ranging from 206 to 265 g; low gain in only the first or third trimester was not associated with a significant decrease in mean in birth weight. The impact of low gain on mean birth weight varied by ethnic group.
These observations suggest that inadequate patterns of prenatal weight gain, defined by IOM guidelines, are associated with decreased birth weight, particularly when the patterns involve low second-trimester gain.
采用美国医学研究所(IOM)的指南,研究孕期体重增加模式与出生体重之间的关联。
来自一项关于胎儿生长受限风险因素的前瞻性随访研究的数据,用于检验低体重增加对平均出生体重的影响。本分析纳入了415名足月分娩的非肥胖(体重指数[BMI]小于26)黑人(n = 275)和白人(n = 140)女性。线性回归分析用于检验孕早期低体重增加(BMI低[小于19.8]时增加少于2.3千克;BMI正常[19.8 - 26.0]时增加少于1.6千克)以及孕中期和孕晚期低体重增加率(BMI低时少于0.38千克/周;BMI正常时少于0.37千克/周)对平均出生体重的影响,同时控制选定的社会人口统计学和生殖变量。
孕早期和孕中期或孕中期和孕晚期体重增加低的模式与平均出生体重显著降低相关,降低幅度在206至265克之间;仅孕早期或孕晚期体重增加低与平均出生体重显著降低无关。低体重增加对平均出生体重的影响因种族而异。
这些观察结果表明,按照IOM指南定义的孕期体重增加不足模式与出生体重降低有关,尤其是当这种模式涉及孕中期体重增加低时。