降低妊娠并发症,孕期体重控制很重要
  • 纳入7866名孕妇队列,收集孕前体重以及孕期体重变化,随访各项母婴结局;
  • 在妊娠晚期,有53.8%的孕妇体重超过美国医学会推荐标准(IOM),且其发生妊娠期高血压、剖宫产、婴儿巨大儿、低血糖等风险均增高;
  • 在妊娠中期超过IOM标准但晚期控制较好的孕妇,相较于妊娠晚期也超标的,其发生上述妊娠并发症和不良结局的风险有所降低;
  • 本研究总结出三类孕期体重增重方式,快速增重者各类妊娠并发症风险均有所增加。
主编推荐语
小笋干儿
本研究通过队列数据,详细记录了孕妇孕期体重变化轨迹,发现孕期增重过大者各类不良妊娠结局及妊娠并发症的风险增高。该研究强调了孕期体重管理的重要性。
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Association of Maternal Weight and Gestational Weight Gain with Maternal and Neonate Outcomes: A Prospective Cohort Study

母亲体重和孕期增重与母婴结局的关联:一项前瞻性队列研究

10.3390/jcm8122074

2019-11-27, Article

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We investigated the association of outcomes with pre-pregnancy body mass index (ppBMI), Institute of Medicine (IOM) recommendations about gestational weight gain, and weight gain trajectories during pregnancy. A prospective cohort of 7866 pregnant women was recruited. ppBMI and weight gain at each follow up visit were collected. The outcomes were gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), caesarean delivery, macrosomia, small (SGA) and large (LGA) for gestational age, neonatal hypoglycemia. Group-based multi-trajectory modelling was used for weight kinetics during pregnancy. In the third trimester, 53.8% of women were above IOM recommendations, with an increased relative risk (RR) of HDP (1.91 (1.40–2.61)), caesarean (1.34 (1.15–1.56)), macrosomia (2.17 (1.77–2.67)), LGA (2.26 (1.83–2.80)), and hypoglycemia (1.89 (1.12–3.18)). Women with a weight gain above IOM recommendations in the second trimester who normalized their weight gain in third trimester had, compared to those who remained above IOM recommendations, fewer events of HDP (2.8% versus 5.3%, p = 0.008), caesarean delivery (16.9% versus 22%, p = 0.006), macrosomia (8.3% versus 14.2%, p < 0.001), and LGA (7% versus 13.2%, p < 0.001). Multi-trajectory modelling identified three profiles with continued variation in RR of complications, including GDM. Weight gain above IOM recommendations increased the risk of perinatal complications. A correction of excessive weight gain in the second trimester reduces these risks.

First Authors:
Damien Bouvier

Correspondence Authors:
Yves Giguère

All Authors:
Damien Bouvier,Jean-Claude Forest,Emilie Dion-Buteau,Nathalie Bernard,Emmanuel Bujold,Bruno Pereira,Yves Giguère

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