Ogunyemi D, Hullett S, Leeper J, Risk A
Morristown Memorial Hospital/Columbia University College of Physicians and Surgeons, New Jersey 07962, USA.
J Matern Fetal Med. 1998 Jul-Aug;7(4):190-3. doi: 10.1002/(SICI)1520-6661(199807/08)7:4<190::AID-MFM5>3.0.CO;2-D.
Relationships between body mass index (BMI) and weight gain with perinatal outcome and birthweight were examined. BMI was calculated on 582 consecutive pregnant women who delivered at or >37 weeks gestational age. Statistical analysis was done using Chi-square tests, analysis of variance, and multiple logistic regression. Of those studied, 13% were underweight, 39% normal, 13% overweight, and 35% obese. Obesity was associated with increasing age (P < .01), multiparity (P < .01), previous cesarean delivery (P < .01), previous macrosomia (P = .01), previous fetal death (P = .03), hypertensive disorders (P < .01), gestational diabetes (P = .02), cesarean delivery (P = .03), and neonatal intensive care unit admission (NICU) (P = .01). The underweight group had the most low birthweight (LBW) infants and the lowest mean birthweight. Ideal weight gain occurred in 31%, inadequate weight gain in 34%, and excessive weight gain in 35%. Inadequate weight gain had increased asthma (P < .05), and hyperemesis (P = .03). Women with ideal weight gain had less smokers (P < .01), fetal distress (P < .05), cesarean delivery (P = .02), and preeclampsia (P < .001). The mean birthweight was highest in the excessive weight gain (P < .01). With multivariate analysis, previous LBW, BMI, and tobacco use were significant predictors of LBW. Normal BMI and ideal weight gain in pregnancy is associated with decreased perinatal complications and an optimum birthweight.
研究了体重指数（BMI）和体重增加与围产期结局及出生体重之间的关系。对582例孕周达到或超过37周并分娩的连续孕妇计算了BMI。采用卡方检验、方差分析和多元逻辑回归进行统计分析。在这些研究对象中，13%体重过轻，39%体重正常，13%超重，35%肥胖。肥胖与年龄增加（P<.01）、多胎妊娠（P<.01）、既往剖宫产（P<.01）、既往巨大儿（P=.01）、既往胎儿死亡（P=.03）、高血压疾病（P<.01）、妊娠期糖尿病（P=.02）、剖宫产（P=.03）以及新生儿重症监护病房收治（NICU）（P=.01）相关。体重过轻组低出生体重（LBW）婴儿最多，平均出生体重最低。理想体重增加者占31%，体重增加不足者占34%，体重增加过多者占35%。体重增加不足与哮喘增加（P<.05）和妊娠剧吐（P=.03）有关。体重增加理想的女性吸烟者较少（P<.01）、胎儿窘迫较少（P<.05）、剖宫产较少（P=.02）以及子痫前期较少（P<.001）。体重增加过多组的平均出生体重最高（P<.01）。多因素分析显示，既往低出生体重、BMI和吸烟是低出生体重的重要预测因素。孕期BMI正常和体重增加理想与围产期并发症减少及最佳出生体重相关。
